慢性阻塞性肺病急性加重期肾功能损害的研究  

Study on Clinical Features of Impairment of Renal Function in the Patients with Chronic Obstructive Lung Diseases in Exacerbations

作　　者：边小曦[1] 杨福荫[2] 何代璇[3] 

机构地区：[1]北京积水潭医院肾内科,100035 [2]北京积水潭医院呼吸内科,100035 [3]北京积水潭医院放免室,100035

出　　处：《中国误诊学杂志》2003年第7期985-987,共3页Chinese Journal of Misdiagnostics

摘　　要：目的　研究慢阻肺 (COPD)急性加重期肾功能损害的特点。方法　观察 2 0例 COPD(分 A、B两组 )急性加重期肾功能的变化 ,与普通肺炎 (C组 )进行比较。结果　急性期所有患者氧分压下降 ,肌酐清除率 (Ccr)降低 ,吸氧后 C组 Ccr上升 ,与治疗前相比有显著差异 (P<0 .0 5 ) ,A组与治疗前相比无显著差异 (P>0 .0 5 )。 COPD伴急性呼衰时 ,随Ccr降低 ,血浆肾素分泌增强。严重缺氧导致尿钠排泄下降 ,尿量减少。高碳酸血症时症状加重 ,可并发急性肾衰。结论　急性呼衰为 COPD肾功能损害的主要原因。Objective To study the clinical features on impairment of renal function in patients with chronic obstructive pulmonary disease (COPD) in exacerbations.Methods The changes of renal function in 20 patients with COPD which were divided into A and B group in exacerbations were observed and were compared with common pneumonia group (group C).Results Arterial blood oxygen tension(PaO 2) and creatinine clearance rate (Ccr )were found decreasing with different grades in all patients . A rapidly increase of Ccr was seen in group C after oxygen therapy ( P<0.05) .The change of Ccr in patients (group A ) was no obvious after therapy (P>0.05) .The level of plasma renin rose with the decline of Ccr when the patients with COPD had developed acute respiratory failure. Severe hypoxia did greatly decrease Na+ and water excretion. The clinical symptoms might deteriorated when patients suffered hypercapnia , and acute renal failure could thus develop.Conclusion Acute respiratory failure played a main role in the development of renal damage.

关 键 词：肺疾病 慢性阻塞性 呼吸功能不全 肾功能衰竭 高碳酸血 

分 类 号：R563.9[医药卫生—呼吸系统]