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目的 探讨姿势性蛋白尿的远期预后、转归及治疗效果。方法 对 116例本病患儿尿蛋白的自然消失时间、转归、治疗效果进行了 5～ 18年的随访。对症状持续存在达 5年以上者进行肾活检检查 ,并分别给予泼尼松 ,泼尼松与环磷酰胺 (CTX)联合治疗。结果 116例患儿中伴持续性蛋白尿者 17例 (肾功能减退 3例 ) ,间歇性蛋白尿伴发作性血尿 6例。对 2 1例症状未消失者肾活检结果示 :微小病变性肾炎 3例 ,系膜增生性肾炎 3例 ,局灶硬化 1例 ,无明显异常 14例 ;此 2 1例给予药物治疗后随访 2～ 5年 ,症状消失无复发 5例 ,偶有发作 4例 ,尿蛋白较前减少 3例。结论 本病大多数预后良好 ,症状消失数年无复发。但仍有 19 8%患儿发展为持续性蛋白尿、血尿及肾功能损害 ,对此应给予治疗
Objective To investigate the long-term prognosis, outcome and therapeutic effect of postural proteinuria. Methods The natural disappearance time, outcome and treatment effect of urinary protein in 116 children with this disease were followed up for 5 to 18 years. Renal biopsy was performed on patients who persisted for more than 5 years and were treated with prednisone, prednisone and cyclophosphamide (CTX). Results Of the 116 children with persistent proteinuria in 17 cases (3 cases of renal dysfunction), intermittent proteinuria with episodes of hematuria in 6 cases. Of the 21 patients whose symptoms did not disappear, the results of renal biopsy showed that there were 3 cases of minimal lesion nephritis, 3 cases of mesangial proliferative glomerulonephritis, 1 case of focal sclerosis and no obvious abnormalities in 14 cases. The 21 cases were followed up 2 ~ 5 years, no recurrence of symptoms in 5 cases, occasional episodes in 4 cases, decreased urinary protein in 3 cases. Conclusion Most of the prognosis of this disease is good, no recurrence of symptoms disappeared for several years. However, 19.8% of children still develop persistent proteinuria, hematuria and renal dysfunction, and should be treated