产后大出血、急性肾损伤

Postpartum hemorrhage and actue kidney injury

青年女性,双胎妊娠产后大出血起病,临床多系统受累,表现为少尿型急性肾损伤(AKI)、急性胰腺炎、急性心功能不全伴肺水肿、贫血、血压升高;尿液检查肾小管指标明显异常,无明显蛋白尿及镜下血尿;抗β2糖蛋白抗体阳性,余自身抗体均阴性。肾活检组织学改变为肾皮质坏死,最终诊断肾皮质坏死。出院治疗1月后随访,尿量增至500 ml/d,肾功能无改善,维持性血液透析2次/周。

A 26-year-old pluripara presented with postpartum hemorrhage and multiple organ dysfunctions including acute kidney injury （AKI）,acute pancreatitis,acute heart failure and pulmonary edema.Renal biopsy was performed and histological examination showed renal cortical necrosis.One month later,her urine volume increased to 500ml per day,while renal function did not recover and still took dialysis twice per week.