64例特发性腹膜后纤维化患者的临床资料分析及药物疗效观察  

Analysis of clinical data and drug efficacy of 64 patients with idiopathic retroperitoneal fibrosis

作　　者：赵帅[1] 侯林欣[1] 张宁[1] ZHAO Shuai;HOU Lin-xin;ZHANG Ning(Department of Rheuamatology,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院风湿免疫科,辽宁沈阳110004

出　　处：《实用药物与临床》2020年第10期908-912,共5页Practical Pharmacy and Clinical Remedies

摘　　要：目的总结特发性腹膜后纤维化(Idiopathic retroperitoneal fibrosis,RPF)患者的临床症状、诊断及药物疗效特征。方法对我院诊断特发性腹膜后纤维化的64例患者的临床资料及用药后疗效进行总结记录。结果所研究病例中,27例(42.2%)患者出现背痛,16例(25.0%)患者出现低热,21例(32.8%)患者出现体重下降3 kg以上的症状,由于下腔静脉受压出现下肢浮肿的患者9例(14.1%);由于输尿管受压梗阻导致排尿困难的患者34例(53.1%),其中无尿并发展为急性肾衰竭的病例6例(9.4%)。通过激素及免疫抑制治疗后,使用环磷酰胺配合激素治疗的患者预后可能较吗替麦考酚酯更好。结论腹膜后纤维化患者常出现背痛、腹痛、排尿困难、低热等症状,经过激素及免疫抑制剂治疗后,大部分患者病情可以达到缓解,环磷酰胺可能比吗替麦考酚酯有更好的疗效。Objective To summarize and analyze the clinical symptoms,diagnosis and drug effect of patients with idiopathic retroperitoneal fibrosis(IRF).Methods The clinical data of 64 patients diagnosed with IRF and the curative effect after drug treatment were summarized and recorded.Results In the cases studied,27(42.2%)patients had back pain,16(25.0%)patients had low fever,and 21(32.8%)patients had symptoms of weight loss of more than 3 kg.Nine patients(14.1%)had edema in the lower extremities because of NC pressure;34(53.1%)patients had difficulty in urinating due to ureteral obstruction,and 6 patients(9.4%)had anuria and developed acute renal failure.After hormonal and immunosuppressive treatment,the prognosis of patients treated with cyclophosphamide combined with hormones might be better than that of the patients with morphicolipid.Conclusion Patients with retroperitoneal fibrosis often experience symptoms,such as back pain,abdominal pain,difficulty in urinating,and low fever.After treatment with glucocorticoid and immunosuppressants,most patients can achieve remission.Cyclophosphamide may be more effective than morphomycolipid.

关 键 词：腹膜后纤维化 肾输尿管积水 糖皮质激素 环磷酰胺 吗替麦考酚酯 

分 类 号：R572.2[医药卫生—消化系统]