原发性肾病综合征并发特发性急性肾功能衰竭的临床特征  

The clinical characteristics of primary nephritic syndrome complicated with idiopathic acute renal failure

作　　者：蒋天如 庄永泽[2] 

机构地区：[1]解放军第100医院内一科,江苏苏州215007 [2]南京军区福州总医院

出　　处：《临床医学》2007年第4期15-16,共2页Clinical Medicine

摘　　要：目的探讨原发性肾病综合征(PNS)并发特发性急性肾功能衰竭(IARF)的临床病理特点、治疗方法及预后。方法回顾分析358例PNS中并发IARF的23例患者的临床病理特点、治疗方法及预后情况。结果IARF发生率为6.4%,23例患者均出现大量蛋白尿及低蛋白血症,血肌酐、尿素氮进行性升高,肾活检病理检查示微小病变肾病13例(56.4%),系膜增生性肾炎3例(13.1%),其共同病理变化是小管间质病变广泛。经泼尼松、速尿和环磷酰胺及血液透析等综合治疗后,91.7%的患者肾功能完全恢复正常。结论IARF以肾小球轻微病变多见,早期综合治疗,其预后较好。Objective To explore the clinical manifestations, pathologic characteristics, treatment and prognosis of primary nephritic syndrome（PNS） complicated with idiopathic acute renal failure（IARF）. Methods Twenty - three cases of PNS complicated with IARF were selected from 358 cases primary nephritic syndrome and their clinical characteristics, pathologic types, treatment and prognosis were analyzed retrospectively. Results The incidence of IARF was 6. 4%, Heavy proteinuria and hypoproteinemia were the maiq clinical manifestations in these cases. Increase of blood urea nitrogen and creatinine occurred. Pathological examination showed minimal change disease 13 cases （56.4%）, mesangial proliferative glomerulonephritis 3 cases （ 13. 1% ）. They all had extensive tubular and interstitial lesion. The renal function in 91.7% of the 23 patients recovered after therapy with prednisone, furosemide, cyclophosphamide and hemodialysis, etc. Conclusion IARF commonly occurres in patients with normal or near normal glomeruli. The earlier multi -modality treatment is given, the better the prognosis.

关 键 词：原发性肾病综合征 急性肾功能衰竭 

分 类 号：R692.3[医药卫生—泌尿科学] R692.5[医药卫生—外科学]