肾小管性酸中毒148例临床分析

Clinical analysis of 148 cases with renal tubular acidosis

目的探讨肾小管性酸中毒(RTA)的病因、分型、临床特点,以助早期诊断及治疗,减少严重并发症的发生。方法回顾性分析148例RTA患者的临床资料。结果病因原发性RTA占34.5%、继发性RTA占65.5%;临床分型Ⅰ型占77.0%、Ⅱ型占9.5%、Ⅲ型占11.5%,Ⅳ型占2.0%。女性RTA病因以原发性干燥综合征多见(27.5%);成人RTA最常见的临床表现为肌无力(75.5%),儿童以生长发育落后多见(57.1%)。结论 RTA临床表现多样,多种疾病可以继发RTA,临床医生要提高对RTA的认识;RTA伴生长发育落后的儿童使用生长激素追赶生长治疗值得重视。

Objective To discuss the cause, types and clinical manifestations of renal tubular aci- dosis and to reduce its severe complications. Methods Review analysis of 148 RTA patienfs clinical ma- terial had been made. Results About 34.5% of patients had primary RTA, secondary RTA account for 65.5 %; among which Type I account for 77.0 %, Type Ⅱ account for 9.5 % ,TypeⅢ account for 11.5 and Type IV account for 2.0% respectively. The main cause of RTA in female was primary sjogren＇s syndrome（27.5 %） . The main clinical manifestation of RTA was muscle weakness（75.5 %）in adults and growth retardation in children（57.1%）. Conclusions RTA has diverse clinical manifestations. Many diseases can cause RTA, Clinician must enhance their understanding about RTA and in RTA patients as- sociated with growth retardation, the use of growth hormone to catch up growth is worth taking.