原发性肾病综合征患儿体重变化及血清瘦素和ghrelin水平的研究

目的了解激素敏感的原发性肾病综合征(SSNS)患儿病程中体重变化及瘦素、胃促生长素(ghrelin)水平情况。方法采用前瞻性调查研究,研究对象为2012年2¹1月在首都儿科研究所附属儿童医院住院的38例SSNS患者及45例正常对照儿童,定期随诊并监测体重变化,以ELISA方法检测血清瘦素和ghrelin水平。结果 SSNS组47.4%在激素治疗111月在首都儿科研究所附属儿童医院住院的38例SSNS患者及45例正常对照儿童,定期随诊并监测体重变化,以ELISA方法检测血清瘦素和ghrelin水平。结果 SSNS组47.4%在激素治疗1²个月时达超重肥胖水平,当激素治疗至平台期时,超重肥胖率降至31.6%。年龄>6岁的患儿(58.3%)及病初BMI>同年龄、同性别50百分位者(74.1%)出现持续肥胖超重的比例显著增加(χ2=4.535,P=0.033;χ2=4.248,P=0.038)。超重肥胖组患儿ghrelin水平较体重正常组和对照组显著降低,瘦素指数(FLI)较对照组明显升高(P<0.05)。结论 SSNS患儿病程中超重肥胖现象较常出现,超重肥胖患儿伴有血ghrelin水平的降低和FLI的升高,病初基础体重、年龄对患儿病程中体重变化有一定影响。

Changes in body weight and its influencing factors in the course of steroid-sensitive syndrome in children

Objective To explore the changes in body weight and its influencing factors in the course of steroid-sensitive nephrotic syndrome（SSNS） in children, improve adherence to clinical treatment and improve the prognosis. Methods For the SSNS group consisted of 38 children that were diagnosed initially and started treatment, height, weight and body mass index（BMI） were measured before treatment, at 1-2 months after treatment and the steroid-reducing plateau; then, the children were assigned to the overweight and obesity group and the normal-weight group on the basis of BMI level at 1-2 months after treatment; the control group was made up of 45 contemporary and sex-matched children from the surgical department and without infectious diseases; ELISA was used to detect serum leptin and ghrelin levels. Results In the SSNS group, 47.4% children reached the overweight and obesity level at 1-2 months after treatment; Those with BMI in early disease 〉the 50 th percentile of the same-age, same-sex, as well as the age of onset〉6 years increased the proportion of overweight and obesity level continuously. It was found that ghrelin level in the overweight and obesity group was significantly lower than the normal-weight group and the control group, but free leptin index（FLI） significantly increased compared with the control group（P〈0.05）. Conclusion Overweight and obesity is common in the course of steroid-sensitive primary nephritic syndrome in children, and the baseline weight in early disease and age are the factors affecting the constant changes of weight.