第1例：突发急性肾衰竭-心肌梗死-贫血  

Acute renal failure complicated with myocardial infarction and anemia： a difficult and complicated casereport

作　　者：杨定位[1] 林珊[1] 李栋[1] 

机构地区：[1]天津医科大学总医院肾内科,300052

出　　处：《中华老年医学杂志》2012年第4期345-346,共2页Chinese Journal of Geriatrics

摘　　要：病历摘要 患者女性,75岁.因双下肢水肿2个月,血肌酐升高1d入院.患者入院前2个月无明显诱因出现双下肢水肿,在当地医院查血白蛋白21g/L,尿蛋白定量7.45g/d,血肌酐95 mmol/L,诊断为肾病综合征,给予雷公藤总甙、辛伐他汀、西洛他唑治疗.入院前1d患者突发心前区疼痛伴一过性意识丧失(约30min),急查血肌酐220μmol/L,心电图异常,收入院.This report presented a case of 75-year-old woman who had received drug treatments two months earlier for nephrotic syndrome and was admitted to our hospital for inferior wall myocardial infarction with elevated creatinine and anemia. Kidney pathology after myocardial infarction showed allergic acute interstitial nephritis which induced acute renal failure. We stopped tripterygium glycosides and used cortical hormone, consequently. Thereafter, the symptoms of renal failure and anemia were improved and we considered tripterygium glycosides resulted in above allergic acute interstitial nephritis and anemia. Therefore, we had to carry out renal needle biopsy in the patient with the elderly nephrotic syndrome before confirmatory treatment to avoid blind use of tripterygium glycosides.

关 键 词：突发急性肾衰竭 心肌梗死 贫血 疑难病例 

分 类 号：R692.3[医药卫生—泌尿科学]