急性肾小管-间质损伤与微小病变型肾综急性肾损伤发生的相关性  

The Relationship Between Acute Tubulointerstitial Lesion and Acute Kidney Injury in Minimal Change Nephrotic Syndrome

作　　者：王淑君[1] 雷文娟[1] 刘华锋[1] 陈观生 姚翠微[1] 

机构地区：[1]广东医学院附属医院肾病研究所,湛江524001 [2]广东省深圳市龙岗区第二人民医院,深圳518000

出　　处：《中国中西医结合肾病杂志》2017年第8期692-695,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：湛江市慢性肾脏病防控重点实验室项目(No.2015A401);湛江市科技计划项目(No.2014A01018);广东医学院科研基金资助项目(No.M2014029)

摘　　要：目的:探讨急性肾小管-间质损伤是否为MCD患者易于发生AKI的病理因素,及其急性肾小管-间质损伤高发的临床因素。方法:回顾性分析MCD患者急性肾小管-间质损伤发生率及损伤程度,对比发生AKI与未发生AKI的MCD患者急性肾小管-间质损伤严重程度;进一步分析临床指标、可疑肾毒性药物的使用与急性肾小管-间质损伤的相关性。结果:MCD患者急性肾小管-间质损伤的发生率为95.6%;MCD患者发生AKI组急性肾小管-间质损伤程度重于未发生AKI组,差异具有统计学意义(P<0.05);血清Alb水平与MCD患者急性肾小管-间质损伤程度呈负相关,而BUN、TG水平与MCD患者急性肾小管-间质损伤程度则呈正相关;使用可疑肾毒性药物组的急性肾小管-间质损伤显著重于未使用组,差异具有统计学意义(P<0.001)。结论:MCD患者普遍存在急性肾小管-间质损伤这一病理改变可能是其AKI高发的病理因素,有效循环血容量不足及可疑肾毒性药物的使用是导致MCD患者急性肾小管-间质损伤及AKI高发的重要因素。Objective： To investigate whether acute tubulointerstitial lesion（ TIL） is the pathological factor of patients with MCD more likely to occur AKI,and clinical factors of high incidence of acute TIL.Methods： The incidence rate and degree of acute TIL in patients with MCD were analyzed retrospectively,and the degrees of acute TIL were compared between the patients with AKI and without AKI; furthermore the effects of multiple clinical indexes and suspicious nephrotoxic drug usage on acute TIL were analyzed.Results： The incidence rate of acute TIL was 95.6% in patients with MCD; and the degrees of acute TIL in the AKI group were severer than the group without AKI（ P〈0.05）.The serum albumin（ Alb） levels showed negative correlation with the acute TIL degrees of patients with MCD,while the levels of serum urea nitrogen（ BUN） and serum triglyceride（ TG） have positive correlation.The acute TIL degrees of patients with MCD used suspicious nephrotoxic drug were apparently severer than patients unused in renal biopsy tissues（ P〈0.001）.Conclusion： Acute TIL may be the pathological factor of patients with MCD who have high level of AKI,lack of effective circulating blood volume,nephrotoxic of suspicious nephrotoxic drug used were the important factors that induced high incidence of acute TIL in patients with MCD.

关 键 词：微小病变型肾病 急性肾损伤 急性肾小管-间质损伤 

分 类 号：R692[医药卫生—泌尿科学]