Abstract: Objective　To understand the clinical characteristics and prognosis of glomerular disease children with Pneumocystis pneumonia (PCP). Method　A retrospective analysis was conducted on the clinical features, laboratory examinations, treatment, and prognosis of 12 children diagnosed with glomerular disease complicated with PCP in Xi'an Children's Hospital from June 2019 to August 2024. Results　Among the 12 children, there were 7 boys and 5 girls, with an age of (10.19±3.29) years old. The basic diseases were mainly lupus nephritis and IgA nephropathy. Shortness of breath was common in the clinical manifestations, but the pulmonary signs were not obvious. Only 3 cases had moist rales heard in both lungs. The lymphocyte count and CD4+ lymphocyte count in the blood of 12 children were both decreased to varying degrees. Among them, the CD4+ lymphocyte count of 10 children was less than 200/ul. The lactate dehydrogenase (LDH) levels of all cases were increased to varying degrees, with a median value of 586.5 (422.0, 1 084.5) U/L. The 1-3β-glucan level of 12 children was (165.27±103.26) ng/L, and 9 of them showed an increase. The other common specific pathogen was cytomegalovirus (5 cases, accounting for 41.67%). All 12 children were treated with sulfamethoxazole-trimethoprim, and 5 of them were also given micafungin. The mortality rate was 33.33% (4/12). Conclusions　For children with glomerulonephritis, if they have fever, cough, and shortness of breath but no obvious lung signs, especially if their CD4+ lymphocyte count is decreased, it is necessary to be vigilant of concurrent PCP. Early diagnosis and treatment should be carried out to reduce the mortality rate.

Key words: Glomerulonephritis, Pneumocystis pneumonia, Children

摘要： 目的　了解儿童肾小球疾病合并耶氏肺孢子菌肺炎（PCP）的临床特征及预后。方法　回顾性分析2019年6月至2024年8月于西安市儿童医院确诊的12例肾小球疾病合并PCP患儿的临床特征、实验室检查、治疗及预后。结果　12例患儿中男7例，女5例，年龄（10.19±3.29）岁，基础疾病以狼疮性肾炎及IgA肾病常见，临床表现以呼吸急促常见，但肺部体征不明显，仅3例双肺可闻及湿啰音。12例患儿血常规淋巴细胞计数、CD4+淋巴细胞计数均有不同程度降低，其中10例患儿CD4+淋巴细胞计数<200/μl；乳酸脱氢酶均有不同程度升高，中位数为586.5（422.0，1 084.5）U/L；12例患儿1-3β葡聚糖水平为（165.27±103.26）ng/L，其中9例升高；比较常见的其余特殊病原体为巨细胞病毒，共5例（41.67%）。12例患儿均给予磺胺甲恶唑-甲氧苄啶治疗，5例同时给予米卡芬净，病死率33.33%（4/12）。结论　肾小球疾病患儿若除发热、咳嗽外伴有呼吸急促但肺部体征不明显，尤其伴CD4+淋巴细胞计数降低，需警惕合并PCP，应早期诊断及治疗，以降低病死率。

关键词: 肾小球肾炎, 耶氏肺孢子菌肺炎, 儿童