55例急性间质性肾炎的临床特点及病因分析

Clinical characteristics and etiological study of 55 patients with acute interstitial nephritis

目的探讨急性间质性肾炎(AIN)的临床特点、病因及治疗与预后。方法回顾性分析1998年1月1日至2021年3月1日期间北京协和医院55例AIN患者的临床及病理资料。结果 55例患者中男性24例(43.6%),女性31例(56.4%),起病年龄为13~69岁,平均年龄为(43±12)岁。55例患者中43例(78.2%)可能是药物相关AIN,其中抗菌药物所致AIN 21例(48.8%),中药方剂10例(23.3%)。在43例药物引起的AIN患者中,37例接受了糖皮质激素治疗。55例患者经过(15±10)个月随诊,42例(76.4%)患者肾功能恢复正常,13例(23.6%)患者进展为慢性肾脏病,随访期内没有患者接受肾脏替代治疗。结论药物因素目前仍是导致AIN的主要原因,糖皮质激素可有效改善AIN的预后。

Objective To explore the clinical characteristics,etiological and pathological characteristics,treatment and prognosis of acute interstitial nephritis(AIN). Methods We collected and analyzed retrospectively the clinical and pathological data of 55 patients with AIN in Peking Union Medical College Hospital from January 1,1998 to March 1,2021. Results Among the 55 patients,24(43. 6%)were male,31(56. 4%)were female. The onset age was 13-69 years old,with an average age of(43±12)years. Among the 55 patients,43(78. 2%)were caused by drugs,of which 21(48. 8%)was caused by antibiotics,10(23. 3%)was by traditional Chinese medicines. Among 43 patients with drug-induced AIN,37 received glucocorticoid therapy. After(15±10)months of follow-up,42 of 55(76. 4%)patients recovered their renal function and 13(23. 6%)developed chronic kidney disease. No patients received renal replacement therapy during the follow-up period. Conclusion Drugs are still important causes of AIN. Glucocorticoid can effectively improve the prognosis of AIN.