隐源性急性肾衰竭80例临床和肾活检病理研究  

CLINICAL MANIFESTATIONS OF 80 CASES OF LATENT ACUTE RENAL FAILURE AND THEIR RENAL BIOPSY

作　　者：马云航[1] 

机构地区：[1]临沂医学专科学校,山东临沂276002

出　　处：《临沂医学专科学校学报》2004年第4期255-257,共3页Journal of Linyi Medical College

摘　　要：目的　探讨隐源性急性肾衰竭的临床表现和肾活检病理改变 ,揭示其病因、影响因素及转归预后 ,提高急性肾衰竭诊治水平。方法　对 80例急性肾实质性疾病所致的急性肾衰竭进行临床分析 ,并作肾活检进行病理研究 ,同时给予治疗。结果　临床诊断原发性肾病综合征 2 8例 ,狼疮性肾炎 12例 ,急性肾炎综合征 15例 ,慢性肾炎 12例 ,紫癜性肾炎 5例 ,药物性肾病 4例 ,妊娠期肾病 2例 ,血管炎 2例。系膜增殖性肾炎 19例 ,狼疮性肾炎 16例 ,新月体肾炎 10例 ,急性间质 小管病变 7例 ,膜、增生性肾炎 5例 ,膜性肾病 2例 ,IgA肾炎 6例 ,紫癜性肾炎 7例 ,硬化性或增生硬化性肾炎 7例 ,微小病变性肾病 1例。治愈 2 1例 ,缓解或部分缓解 4 9例 ,无效 5例 ,死亡 5例。结论　隐源性急性肾衰竭以肾小球病变占绝大多数 ,病理表现为肾小球损害且多合并肾间质 小管损害 ,激素疗法与透析联合治疗可使多数肾功能衰竭得到恢复 ,尽早肾活检明确病理诊断可显著提高治愈率。Objective To analyze the clinical manifestations of latent acute renal failure in cases and to explore the pathological changes according to renal biopsy so as to effectively prevent and treat acute renal failure (ARF).Methods The manifestations of ARF caused by acute renal parenchyma diseases in 80 cases were analyzed and renal biopsy was performed to detect the causes of the disease.Clinical treatments were given to these cases..Results Clinical diagnoses showed that there existed 28 cases of primary nephrotic syndrome,12 lupus nephritis,15 acute nephrotic syndrome,12 chronic nephritis,5 prupuric nephritis,4 drug nephrosis,2 nephrsis in pregnancy and 2 vasculitis.Renal biopsy showed that there existed 19 cases of mesenteric proliferative nephritis,16 lupus nephritis,10 crescent nephritis,7 acute interstitial tubular lesions,5 membrano-proliferative nephritis,2 membranous nephritis,6 IgA nephritis,7 purpuric syndrome,7 sclerotic or proliferative nephritis and 1 nephritis of minute lesion.21 cases were cured.Remissions or partial remissions were got in 49 cases.No effects were got in 5 cases and deaths occurred in 5 cases.Conclusion The cases of glumerulopathy account for the majority of the cases of patent acute renal failure.Pathological manifestation is the combined occurrence of glomerulous defects and interstitial tubular defects.Most cases can recover when treated with hormonotherapy and dialysis therapy.Curative effects can be greatly promoted if early renal biopsy is performed to get the definite diagnoses.

关 键 词：急性肾衰竭 隐源性 病理 

分 类 号：R692.5[医药卫生—泌尿科学]