376例恶性疟患者蛋白尿的临床分析

A Clinical Analysis of Proteinuria in 376 Patients with Subtertian Malaria

目的 :探讨恶性疟患者的尿蛋白变化规律和特征。方法 :回顾性统计恶性疟患者病程中的尿蛋白演变情况 ,用统计学方法进行分析、比较。结果 :微量蛋白尿者占 2 8.19% ,轻度蛋白尿者占 2 3.6 7% ,中度蛋白尿者占 8.2 4% ,重度蛋白尿者占 1.6 0 % ;出现轻度以上蛋白尿的时间开始于发病第 2天 ,以后持续存在 ;在恶性疟患者治愈后 ,蛋白尿大多于 1周内恢复 ;蛋白尿的严重程度与个体差异性和发热程度有关。结论 :恶性疟的蛋白尿部分属于良性、功能性的 ,多数为病理性的。它与个体差异、发热程度和免疫因素有关。是否及时恰当地进行抗疟治疗是影响预后的重要因素。

Objective: To investigate the trends and the characteristics of proteinuria in 376 patients with subtertian malaria. Methods: The complete clinical information of 376 patients with subtertian malaria was collected and the data concerning proteinuria were analysed and compared statistically. Results: 28.19% of the patients had +- proteinuria; 23.67% percent had + proteinuria; 8.24% had ++ proteinuria; 1.60% had +++ proteinuria. Proteinuria usually occurred on the 2nd day after the onset of subtertian malaria. Proteinuria would decrease or vanish in most patients within a week after the disease had been controlled. Proteinuria occurred more commonly in patients with high fever of more than 39 ℃. Conclusion: Subtertian malaria usually causes functional proteinuria and the prognosis is usually good. Individual differences, fever grade, deposition of immune complexes and prompt cure are associated with positive proteinuria.