急性肾功能衰竭的病理特点及其临床表现  

The Pathological Features and Clinical Manifestations of Acute Renal Failure

作　　者：王慧[1] 李增艳[1] 王彩丽[1] 

机构地区：[1]包头医学院第一附属医院肾内科,内蒙古包头014010

出　　处：《包头医学院学报》2013年第1期25-27,共3页Journal of Baotou Medical College

摘　　要：目的:探讨急性肾功能衰竭(ARF)患者的肾脏病理特点及其临床表现,为临床诊断提供依据。方法:回顾性分析108例经肾穿刺活检确诊ARF患者的病理特点和临床资料。结果:ARF患者中微小病变肾病和膜性肾病的肾病综合征表现高于其它组,且以单纯蛋白尿为主,前者ARF的发生率高于后者。新月体肾炎的患者年龄偏高,起病快,血肌酐迅速升高,半数以上有贫血现象,40.0%的患者肾穿前需行血液透析。肾小管间质病变的患者72.7%有服药史。肾小管坏死的患者尿中蛋白量明显高于间质性肾炎,血肌酐值高于间质性肾炎。研究还发现不能以尿量改变来推断ARF的病理类型。结论:对于ARF患者应严格掌握肾穿刺活检的适应证,早期诊断、明确病因、采用适当有效的治疗措施,有利于ARF的及早恢复并降低病死率。Objective： To discuss the renal pathological features and clinical manifestations of patients with acute renal fail- ure （ARF）, and to provide references to the diagnosis of ARF. Methods ： The pathological features and clinical data of 108 pa- tients with ARF diagnosed by renal needle biopsy were retrospectively analyzed. Results： For patients with ARF, the clinical ne- phritic syndrome resulted from minima - change nephropathy and membranous nephropathy was more serious than from others, and was characterized as pure proteinuria. The ARF incidence of minima - change nephropathy was higher than that Of membra- nous nephropathy. The traits of patients with crescent glomerulonephritis were as follows ： older, fast onset, rapidly increased ser- um creatinine, majority having anemia, and 40 % patients needing hematodialysis. 72.7 % patients with tubulointerstitial le- sions had experiences of taking medicine. Urine protein and serum creatinine in patients with renal tubular necrosis were much higher than in cases with tubulointerstitial lesions. Furthermore, the pathological types of ARF could not be deduced by urine output. Conclusion： The renipuncture indication of patients with ARF should be controlled strictly. Early diagnosis, well - de- fined causes and effective therapeutic measures are good for the recovery of patients with ARF.

关 键 词：急性肾功能衰竭 肾穿刺活检 病理特点 临床表现 

分 类 号：R692.5[医药卫生—泌尿科学]