21例急性肾梗死患者的的诊治及预后分析  

Clinical characteristics, treatment and prognosis of acute renal infarction： an analysis of 21 patients in a single center

作　　者：熊辉[1] 汪波[1] 李秀清[1] 王逸群[1] 李晓晶[1] 田亚男[1] 冯莉莉[1] 

机构地区：[1]北京大学第一医院急诊科,北京100034

出　　处：《中国急救医学》2014年第7期609-612,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的分析急性肾梗死（ARI）的临床病例特点，为临床及早诊断ARI提供线索。方法回顾性分析2003～2012年我院诊断ARI的21例患者病历，从临床表现、辅助检查、治疗和预后等资料进行分析。结果21例患者引起ARI的病因主要是心源性因素（42．8％）；最常见的症状和体征是腹痛（42．8％）和侧腹痛（33．3％）；常见的化验检查异常是乳酸脱氢酶（LDH）升高（90．4％）、蛋白尿（71．4％）和血尿（52．3％）。从初诊到做CT确诊的时间（5．1±4．4）d，仅6例（28．5％）在最初就诊于急诊科即诊断ARI。所有患者均接受抗凝治疗和（或）溶栓治疗，全部患者出院时临床症状均有所改善。结论ARI的临床表现和实验室检查缺乏特异性，早期诊断依赖急诊科医生对ARI的认知。抗凝治疗和（或）溶栓治疗对患者均可获益。Objective To analyse clinical characteristics of patients with acute renal infarction. Methods Twenty- one patients with acute renal infarction, diagnosed in Peking University First Hospital, were retrospectively recruited. Clinical and laboratory data, treatment and prognosis were analysed. Results Among the 21 patients with acute renal infarction, the most common cause was cardiogenic dieseases （42.8%）. The common symptoms and signs included pain in abdomen （42.8%） and lateral abdomen （33.3%）. The common abnormalities in laboratory tests included elevated LDH （90.4%）, proteinuria （71.4%） and hematuria （52.3%）. The time from presentation to receiving computer tomography examination was （ 5. 1 ± 4. 4 ） d. The diagnosis of acute renal infarction was established by the emergency department in only 6 patients （28. 5% ）. All the patients received anticoagulation and （or） thrombolysis treatment, and symptoms were relieved in all the patients. Conclusion The early recognition of acute renal infarction, whose clinical manifestation and laboratory tests are often nonspecific, needs special attention for physicians in the emergency department. It is associated a number of extra - renal diseases. Anticoagulation and （or） thrombolysis treatment is beneficial.

关 键 词：急性肾梗死(ARI) 治疗 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]