35例原发性肾病综合征合并急性肾衰的分析和治疗

ANALYSIS AND TREATMENT OF 35 CASES WITH PRIMARY NEPHROTIC SYNDROM ASSOCIATED ACUTE RENAL FAILURE

目的 :分析原发性肾病综合征 ( NS)合并急性肾衰 ( ARF)的发病因素、特征、治疗和预后。方法 :全部病例检查尿蛋白定量、生化指标及血流变学 ,1 9列进行了肾活检。结果 :发病年龄多在 45岁以下 ( 85.74% ) ,男性为 80 % ,1 9例肾活检结果以轻微病变为多 ( 68.42 % ) ,均有肾间质水肿和肾小管细胞的变性、坏死。予以激素、利尿剂及尿激酶治疗 ,个别人进行血液透析后取得满意效果。结论 :NS合并 ARF发病年龄轻 ,病理以轻微病变多见 ,经尿激酶和常规治疗肾功能多可恢复 。

Objective:To analyse the pathogenesis factor, clinicopathologic charateristics, treatment and prognosis of nephrotic syndrome (NS) associated acute renal failure (ARF) Methods:Urinary protein quantitative analysis ,biochemical index and hemorrheology were tested in all cases 19 of them received kidney biopsy Results: All the cases accorded to diagnosis criterion of NS and ARF associated hyperviscosity The age in most cases belowed 45(85 74%),80% of them were male (68 4%)of those who had received kidney biopsy showed minimal change kidney biopsy of 19 cases indicated tubulo in terstitium edema, degeneration and necrosis of renal tubular cells Hormone, diuretic and urokinase were used to treat the patients and some of them were treated with hemodialysis The treatment effect was satisfactory Conclusion:Pathogenic age of NS associated ARF was low and minimal change was commonly seen in pathology Through urokinase and routijne treatment, kidney function could be mostly recovered it was suggested that microthrombosis in kidney be not neglected