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通过比较我国与印度的儿童激素敏感型肾病综合征(SSNS)诊治指南,发现中国与印度指南诊断肾病综合征(NS)的2个必要条件基本一致,SSNS定义和SSNS初治方案相同;但在NS分型、肾活检指征、转诊指征和免疫接种等方面不同。借鉴印度指南,对我国指南的修订提出7点建议:在大量蛋白尿定义中增加“或尿清蛋白排出量>40 mg.m-2.h-1”;将低蛋白血症的定义修改为“血清清蛋白<25 g.L-1”;删除按临床表现分类,代之以“对临床表现为肾炎型肾病者做肾活检”;按糖皮质激素反应分型“将原发性NS分为SSNS和激素耐药型NS 2型”;增加“NS肾活检指征”;增加“转诊于儿童肾脏病专科医师的指征”和“原发性NS患儿免疫接种”原则。
By comparing the guidelines for the diagnosis and treatment of children with hormone-sensitive nephrotic syndrome (SSNS) in our country and India, we found that the two necessary conditions for the diagnosis of nephrotic syndrome (NS) in China and India are basically the same. The definition of SSNS is the same as that of SSNS. However, NS typing, renal biopsy indications, referral indications and immunization and so different. Drawing on the Indian guidelines, we made seven recommendations for the revision of our guidelines: Increase the “” or urinary albumin excretion> 40 mg.m-2.h-1 “in the definition of large amounts of proteinuria; define hypoproteinemia Revised to ”serum albumin <25 gL-1“; delete according to the clinical manifestations, instead of ”clinical manifestations of nephritis patients with renal biopsy“; according to glucocorticoid response type ” Primary NS divided into SSNS and steroid-resistant NS2 type “; increase” NS renal biopsy indications “; increase” referral to pediatric nephrologists indications “and” primary Sexual NS children immunization "principle.