急性肾梗死的临床诊断(附3例报告并文献复习)

Diagnosis of acute renal infarction(Report of three cases and review of literature)

目的：总结急性肾梗死的临床特点，提高对急性肾梗死的诊断水平。方法：回顾性分析3例急性肾梗死患者的临床资料：男2例，女1例，临床表现为腰和（或）腹部疼痛4小时～2天；均采集病史并给予相关实验室、腹部彩超及上腹部CT增强检查。结果：3例患者血清乳酸脱氢酶（LDH）均有不同程度升高；双肾彩超均未见异常；腹部CT增强检查明确急性肾梗死。结论：急性肾梗死临床少见，因缺乏特异性而易延误诊治。基层医院超声检查对急性肾梗死诊断价值有限但有利于鉴别诊断，及时行CT增强检查有助于早期诊断和指导治疗。

Objective： To summarize the clinical characteristics of acute renal infarction so as to enhance the level of diagnosis. Method： We analyzed the data of three cases including two males and one female retrospectively. All patients suffered from progressive abdominal pain and severe back pain for four hours to two days were admitted to the emergency room. The laboratory data, abdominal color Doppler ultrasonography and further abdominal en- hanced CT scan were taken. Result.. The value of lactic dehydrogenase （LDH） increased from 352 U/I, to 435 U/ L. Abdominal color Doppler ultrasonography showed no abnormity in any case and abdominal enhanced CT scan confirmed acute renal infarction. Conclusion： Acute renal infarction is rare. It is hard to be detected for lack of specificity. Abdominal ultrasonography plays a certain role in differential diagnosis. However, timely abdominal en- hanced CT scan will help to diagnose and instruct the treatment.