先天性肾性尿崩症临床特点  

Clinical characteristics of congenital nephrogenic diabetes insipidus

作　　者：张颖辉[1] 李志臻[1] 李珊[1] 孟栋栋[1] 秦贵军[1] Zhang Yinghui;Li Zhizhen;Li Shan;Meng Dongdong;Qin Guijun(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院内分泌科,450052

出　　处：《中华内科杂志》2021年第7期665-668,共4页Chinese Journal of Internal Medicine

摘　　要：为提高对先天性肾性尿崩症(congenital nephrogenic diabetes insipidus,CNDI)的临床认识和诊治水平,回顾分析郑州大学第一附属医院2013年5月—2020年5月收治的22例CNDI患者的临床表现、实验室检查、影像学表现及治疗效果。22例CNDI患者中男性占86.4%(19例);年龄2个月~47岁,小于30岁者20例,大于30岁者2例。临床表现为自幼出现多饮、多尿,伴有不同程度的发热、生长发育障碍,部分患者出现血肌酐增高。15例(68.2%)患者有不同程度双肾及输尿管积水,残余尿增加。垂体磁共振成像(MRI)增强扫描显示,垂体后叶高信号未见明确显示5例,占22.7%,垂体后叶显示模糊6例,占27.3%。7例行基因检测为AVPR2基因突变。对疑似CNDI的患者应及时行禁水-加压素试验及基因检测明确诊断,早期治疗。The purpose of this study was to improve the ability to visualize and diagnose congenital nephrogenic diabetes insipidus(CNDI).The clinical manifestations,laboratory examination findings,imaging features and treatment outcomes of 22 patients with CNDI admitted to the First Affiliated Hospital of Zhengzhou University from May 2013 to May 2020 were retrospectively analyzed.Among the 22 patients with CNDI,86.4%(19 cases)were male.The age of the 22 patients ranged from 2 months to 47 years old,in which 20 cases were younger than 30 years old and 2 cases were older than 30 years old.The clinical manifestations were polydipsia and polyuria,accompanied with various degrees of fever,defects in growth and development,and increased serum creatinine in some patients.Fifteen patients(68.2%)had different degrees of bilateral kidney and ureteral hydronephrosis,and increased residual urine volume in the bladder.Pituitary magnetic resonance imaging(MRI)enhanced scan showed that the high signal intensity in the posterior pituitary lobe was not detectable in 5 cases(22.7%),and blurred in 6 cases(27.3%).Seven tested patients were all found AVPR2 gene mutation.For patients with suspected CNDI,water-inhibiting vasopressin test and genetic testing should be performed in time so as to confirm diagnosis and treat as early as possible.

关 键 词：尿崩症 肾性 血管升压素类 水通道蛋白质2 

分 类 号：R584.3[医药卫生—内分泌]