肾脏内科门诊480例腰痛患者病因分析  

Analysis on etiogenic causes of lumbago in 480 patients from nephrology clinic

作　　者：安军民[1] 张莉[1] 孟梅霞[1] 畅飞[1] 邢继龙[1] 

机构地区：[1]西安市第四医院肾内科,陕西西安710004

出　　处：《临床和实验医学杂志》2010年第8期578-579,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的总结肾内科门诊腰痛患者的病因分布特点以及腰痛与肾脏病的关系。方法对我院5年来肾脏内科门诊就诊的腰痛患者480例行尿常规、尿蛋白定量、尿红细胞形态、肝肾功能、人白细胞抗原B27(HLAB27),腰腹部X线、B超、CT等相关检查,结合病史、症状、体格检查分析腰痛的病因。结果480例腰痛患者中男性260例,女性220例。其中与肾脏相关者174例,占36.3%,前5位为肾盂肾炎56例,急性肾炎23例,肾囊肿21例,肾病综合征19例,肾结石12例。肾外疾病引起腰痛的患者共306例,前5位包括软组织性腰痛57例,腰背部组织结构退行性变43例,腰椎间盘突出症41例,神经源性腰痛22例,盆腔炎22例。结论腰痛的病因相当复杂,有时需要十分复杂的检查才能最终确诊,肾性腰痛所占比例并不大。而非肾性腰痛患者常到肾内科门诊就诊,故作为肾科医师应熟悉对常见腰痛,尤其是肾区腰痛的诊断。Objective To summarize the characteristics of cause distribution and relationship between lumbago and renal diseases in patients with lumbago from nephrology clinic. Methods Four hundred and eighty outpatients with lumbago from nephrology clinic in this hospital during the past 5 years were asked to take urine test, urine protein determination, morphological examination of urinary red cells, liver function test, renal function test, examination of HLAb27, X -ray examination on waist and abdomen, B type uhrasonography, CT scanning etc. Their resuits in combination with medical history, symptoms and physical examination were analyzed for the cause of low back pain. Results Among 480 patients with lumbago, 260 were males and 220 females. The etiogenic causes for lumbago in 174 cases （36.3 % ） were kidney - related. The top 5 causes were nephropyelitis （56 cases）, acute nephritis （23 cases）, renal cyst （21cases）, nephrotic syndrome （19 cases） and nephrolithiasis （ 12 cases）. The lumbago in remaining 306 patients were not related to kidney, and the top 5 causes were disease of soft tissue （57 cases）, degeneration in lumbar and back part （43cases） , lumbar intervertebral disc protrusion （41 cases） , neuropathic low back pain （22 cases） and pelvic inflammation （22 cases）. Conclusion The causes for lumbago are very complicated. Sometimes they need very complicated examinations to give the final diagnosis. Renal diseases are the minor causes for lumbago. Patients with lumbago often go to nephrology clinic for diagnosis and treatment. As a physician of the department of nephrology, we should be familiar with the differential diagnoses of lumbago, especially lumbago occurred in renal region.

关 键 词：腰痛 肾脏 病因分析 

分 类 号：R692[医药卫生—泌尿科学] R441[医药卫生—外科学]