原发性肾病综合征并发急性肾损伤临床救治与疗效分析

Aualysis on the Clinical Treatment and Curative Effect of Primary Nephrotic Syndrome Complicated by Acute Kidney Injury

目的探讨原发性肾病综合征合并急性肾损伤的临床救治效果及安全性。方法以近5年来攀枝花煤业集团公司总医院收治的原发性肾病综合征并发急性肾损伤16例患者为研究对象,均接受糖皮质激素治疗,其余对症支持,疗效不佳者给予血液透析治疗。观察患者的血浆白蛋白、尿量、24 h尿蛋白定量、血肌酐、尿素氮和胆固醇的改善情况。结果完全缓解率为62.50%,部分缓解率为31.25%,总缓解率为93.75%,无严重不良反应出现。结论肾病综合征并发急性肾损伤是一种急性可逆性的肾损害,早期诊断、纠正可逆因素,糖皮质激素、利尿剂和血液透析等积极综合治疗,可改善肾功能,缓解症状,是有效及相对安全的疗法。

OBJECTIVE discuss the clinical treatment of primary nephritic syndrome complicated by acute kidney injury and its safety.METHODS 16 such cases in the past 5 years were observed and took glucocorticoid treatment and corresponding individual treatment,and those with poor effects would receive hematodialysis. Mend matters of plasma-albumin, urine volume, 24 h urine protein quantita-tion, serum creatinine, urea nitrogen, cholesterol of the patients were observed. RESULTS The complete remission rate（CRR） was62.50%, partial remission（PR） was 31.25%, total remission rate was 93.75%, and no severe bad reaction observed. CONCLUSION The conclusion was nephritic syndrome complicated by acute kidney injury was an acute but reversible renal damage, with positivecomprehensive treatment such as early diagnosis, recitification of reversible factors, glucocorticoid, diuretic, hematodialysis, improv-ability of renal function and remissions of symptoms could be realized, and this positive comprehensive treatment was effective andrelatively safe.