尿毒症肺49例临床表现及胸部X线分析

Clinical Analysis of 49 Cases with Uremic Lung

目的:进一步了解尿毒症肺的临床表现及胸部X线特点。方法:对北京大学人民医院1998～2001年住院的49例尿毒症肺患者进行临床表现和胸部X线特点分析。结果:住院慢性肾功能不全尿毒症期病人141例,其中尿毒症肺的病人49例(34.75％)。无症状者11例(22.45％),咳嗽、咳痰者20例(40.81％)。呼吸困难27例(55.10％);胸部X线表现为肺淤血期20例(40.81％),肺泡性肺水肿期20例(40.81％);血清尿素氮(25.05±9.57)mmol/L,血清肌酐(730.49±251.87)μmol/L。全部病例进行了血液透析治疗,死亡5例(10.2％),结论:临床症状以咳嗽、咳痰、呼吸困难为主,胸部X线表现以肺淤血,肺泡性肺水肿多见。其形成原因与血尿素氮、肌酐、血压及左心衰竭等因素有关。最有效的治疗方法是血液透析。

Objective: To understand the clinical situation and the appearance of chest X - ray in uremic lung. Methods: clinical and chest X-ray analyses were performed in 49 patients with uremic lung between the beginning of 1998 and the end of 2001 in our hospital. Results: 141cases of uremia were diagnosed in adult population, 49(34.75%)of them with uremic lung, in which 11 cases (22.45%)were asymptoms, 20 cases(40.81%) had cough and sputum. 27 cases(55.10%) felt dyspnea. The chest X - ray finding in these group of patients were characterized by pulmonary vascular congestion (20cases, 40.81%) and alveolar edema (20cases,40.81%). Blood urea nitrogen was (25.05±9.57)mmol/Land creatinine was (730.49±251.87)μmol/L,All the cases of uremic lung were treated with hemodialysis. 5 cases(10.20%) were died.Conclusion: The clinical symptoms of uremic lung are cough,sputum and dyspnea. The findings of the chest X - ray are pulmonary vascular congestion and alveolar edema. The pathogene-sis of uremic lung was postulared to be related to blood urea nitrogen , creatinine retention, hypertension and left side heart failure. Hemodialysis is the best adminstration to resolve uremic lung edema and relife the clinical symptoms.