透析患者钙化防御的治疗  

Treatment of calciphylaxis in dialysis patients

作　　者：杨璨粼 刘玉秋[1] 张晓良[1] YANG Canlin;LIU Yuqiu;ZHANG Xiaoliang(Institute of Nephrology,Zhong Da Hospital,Southeast University School of Medicine,Nanjing 210009,China)

机构地区：[1]东南大学医学院东南大学附属中大医院肾内科

出　　处：《肾脏病与透析肾移植杂志》2019年第6期580-585,共6页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：钙化防御又称钙性尿毒症性小动脉病(calcific uremic arteriolopathy,CUA),是一种致命的缺血性皮肤坏死性疾病,伴有剧烈疼痛。钙化防御常见于终末期肾病长期接受透析治疗的患者,典型的组织病理学特征为小动脉中膜钙化、真皮和皮下组织血栓形成,皮肤活检是钙化防御诊断的金标准。该病罕见,预后极差,缺乏指南或共识指导治疗。目前,基于病例报告及临床研究结论,逐步形成了以减少或去除诱因、疼痛管理、伤口护理、药物治疗和高压氧治疗等五大方面钙化防御系统性治疗方法。本文对近年来钙化防御的相关文献进行综述,重点介绍了近3年该病的治疗进展,以期提高钙化防御的规范化治疗水平。Calciphylaxis is a fatal painful ischemic cutaneous necrotic disease and mainly occurred in maintenance dialysis patient.Typical histopathological features are systemic arteriolar membranous calcification,intimal fibrosis and thrombosis so that skin biopsy is the golden standard of diagnosis.Therefore,calciphylaxis is also known as calcific uremic arteriolopathy(CUA).Calciphylaxis is a rare disorder with poor prognosis and there is no guidance or consensus of the treatment currently.However,on the basis of cases reports and clinical studies,systematic treatments including reducing or eliminating risk factors,pain management,wound care,medication and hyperbaric oxygen therapy have been gradually formed.This article reviews the recent retrospective data and clinical experience of treatment in calciphylaxis to help with the standardized management.

关 键 词：钙化防御 钙性尿毒症性小动脉病 终末期肾病 透析 治疗 

分 类 号：R692.5[医药卫生—泌尿科学]