妇科分清丸所致马兜铃酸肾病的临床和病理特点

Clinical and pathological features of aristolochic acid nephropathy induced by Fukefenqing pills

目的探讨妇科分清丸所含马兜铃酸对肾脏、肝脏和血液系统的毒性作用及治疗途径。方法收集该院2003￣2004年14例由妇科分清丸所致马兜铃酸肾病(AAN)病人的临床和病理资料,并用前列腺素E1(10μg/d)静点或静推10￣14d治疗。结果妇科分清丸含有关木通,能引起血液、消化和肾脏等多器官功能障碍,症状出现早而严重。该组病人住院期间应用前列腺素E1治疗后血肌酐下降而血红蛋白水平升高(P<0.05)。结论马兜铃酸可能引起前列腺素系统或其他影响肾脏血流量的血管活性因子异常,所以改善微循环治疗对改善AAN的肾功能损伤有效,但是用量及疗程尚有待于进一步探讨。

[Objective] To dicuss the toxicity of the aristolochic acid in Fukefenqing pills. [Methods] 14 patients who had eaten the pills for mort than half a month were enrolled in the study in 2003-2004 at the department of nephrology of Chinese medical university. Collecting their clinical data and using Prostaglandin E1 （10 μg/d） intravenous drop for 10-14 days. [Results] Fukefenqing pills have Guanmutong, it can cause multiple organs lesions, and the symptom is severe. The serum crtatinine and hematoglobin before and after therapy were statistically different. [Conclusion] Aristolochic acid possibly causes abnormal of the system of prostaglandin or other blood vessel cytokines, so improving of microciroulation wiU be effect in therapy. But the content and course of treatment need to be studied furthedy.