目的：探讨NPHS2基因突变所致激素耐药型肾病综合征的临床特点。方法回顾分析2例NPHS2基因突变所致激素耐药型肾病综合征患儿的临床资料，并结合文献进行复习。结果2例患儿均为男性，发病年龄2岁、3岁。临床表现为大量蛋白尿、低白蛋白血症、高胆固醇血症。肾脏病理1例为局灶节段性肾小球硬化，另1例为微小病变。均伴有反复发作性腹股沟斜疝，1例伴左侧睾丸发育不全。相关基因检测均证实存在NPHS2突变。病初即激素耐药，其后激素联合多种免疫抑制剂治疗仍无效。发病3年内均进入终末期肾病阶段。结论对于激素耐药性肾病综合征男性患儿，伴多发疝或睾丸发育异常等肾外表现时，应注意除外NPHS2基因突变所致遗传性肾病综合征可能。%Objective To explore the clinical features of steroid resistant nephrotic syndrome caused by NPHS2 gene mutation. Methods The clinical data of two pediatric patients with steroid resistant nephrotic syndrome were retrospectively analyzed. The pertinent literatures were reviewed. Results Both patients were male with onset age at 2 and 3 years old. The clinical features were heavy proteinuria, hypoalbuminemia, and hypercholesterolemia, which met the diagnostic criteria of nephrotic syndrome. Renal pathology found one patient with focal segmental glomerulosclerosis, and other with minimal-change. Both of them suffered from recurrent inguinal hernioplasty and one was accompanied with hypoplasia of left testis. Gene detection verified a NPHS2 gene mutation. Both of them were hormone resistant at the beginning of onset and later hormone combined with different kinds of immunosuppressive therapy was still ineffective. Both of them entered the end-stage of renal disease 3 years after onset. Conclusions For male pediatric patients with steroid resistant nephrotic syndrome, combined with non-renal manifestations such as multiple hernia or testicular abnormalities, the possibility of the hereditary nephrotic syndrome caused by NPHS2 mutations should be considered.
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