摘要
目的 :结合肾活检及近期检验时展 ,了解急性间质性肾炎 (AIN)的临床表现。方法 :对 1 997年～ 2 0 0 0年 6月间的 35例AIN患者进行病因分析、常规、免疫学、肾小管功能、B超、肾活检检查。结果 :病因方面 :感染 1 3例 ,自身免疫性疾病 3例 ,白血病 3例 ,单纯药物 2例 ,感染、药物共同作用者 1 1例 ,不明原因者 3例。临床表现 :发热 2 4例 ,皮疹 2例 ,高血压 7例 ,眼睑及双下肢浮肿 8例 ,35例均有急性肾功能衰竭 (ARF) ,其中少尿型 1 2例。尿常规检查 :镜下血尿 1 5例 ,肉眼血尿 5例 ,2 4h尿蛋白定量 :在 0 .1 5g～ 3.5g之间 ,尿钠升高 6 /1 8例。 1 2例患者血气分析提示 1 0例存在代谢性酸中毒。IgE9/1 8例升高。 2 3例行B超检查 ,1例双肾体积增大 ,7例皮质回声增强。伴小管病变 4例。 9例使用激素 ,肾功能恢复时间缩短。结论 :AIN病因多样 ,临床表现各异 ,早期诊断、及时合理治疗 ,有助于疾病的痊愈或使病情得到不同程度的逆转。
Objective:To further observe the clinical manifestations and pathlolgical changes in acute interstitial mephritis(AIN).Methods:35patients(pts) with AIN in our department during 1997 to 2000 were studied.The etiology and the results of urine tests,immunology test,renal function tests,ultrasonography(US) and renal biopsy were analyzed.Results:The causes of AIN were infestion(13),auto-immune disease (3),leukemia(3),drugs(2),combination of infection and drugs(11) and unknown(3),24 pts presented with fever,2 pts with dermatitis and 7 pts with hypertension.All patients developed acute renal failure in which 12 patients were oliguric.Urine dipstick showed 15 microscopic hematuria and 5 gross hematuria.The patients had 24h proteinuria of less than 0.15g(9 pts), 0.15～1.0g(20 pts),1.0～3.5g(5 pts) and grester than 3.5g(1 pts).6 pts had hign urine sodium excretion in 18 pts.Moreover,10 in 12 pts suffered metabolic acidosis.Serum IgE lever was elevated in 9/18 patients.One patient had enlarged kidmeys in 23 pts whom were performed US measurement.All renal tissues presented with inflammatory cells infiltration in the interstitium and 4 accompanied by renal tubular lesions. Steroids were introduced in the treatment of 9 pts whose renal function recovered much shorter than other patients.Conclusion:The etiology of AIN is complicated and the clinical manifestations are different.Early diagmosis and proper treatment may be benefit for the prognosis of AIN.
出处
《长治医学院学报》
2001年第4期13-14,共2页
Journal of Changzhi Medical College
