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子痫前期患者产后10周患急性粟粒性肺结核并急性肾损伤一例分析 被引量:2

A case of acutemiliary tuberculosis with acute kidney injury at 10 weeks after delivery in a preeclampsia patient
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摘要 病例资料患者,女,31岁,主因“产后发热、咳嗽1个月,周身浮肿1周”入院。患者于产后10周(有肺结核患者接触史)出现咳嗽、咳痰,痰中带血丝,伴乏力、潮热,体温最高达39.4℃,体质量下降3 kg,就诊我院传染科。查胸片示两肺多发细微小结节。进一步胸部CT示双肺多发细微小结节,考虑急性血型播散型肺结核。化验检查:血常规示白细胞(WBC)13.54×10^9/L,中性粒细胞比例(neutrophil,NEUT)93%,红细胞(RBC)4.34×10^12/L,血红蛋白(Hb)106 g/L,血小板(PLT)245×10^9/L;红细胞沉降(erythrocyte sedimentation rate,ESR)37 mm/h;结核抗体(-);肝功能示丙氨酸转氨酶(ALT)93.9 U/L,天冬氨酸转氨酶(AST)52.0 U/L,AST/ALT 0.55,碱性磷酸酶76.3 U/L,前白蛋白(PA)186 mg/L,总蛋白50.5 g/L,白蛋白(Alb)30.3 g/L;肾功能示尿素氮(BUN)6.65 mmol/L,血肌酐(Scr)50.2μmol/L,BUN/Scr 32.8;尿常规示蛋白质(±),潜血(-),白细胞(-),比重1.020;感染三项:降钙素原6.87 ng/mL,C反应蛋白75.41 mg/L;结核杆菌特异性细胞免疫反应监测示(+);痰液涂片抗酸染色示抗酸杆菌(+);血培养结果为人葡萄球菌。
作者 陈建丽 赵孟德 CHEN Jian-li;ZHAO Meng-de(Department of Nephrology,Wuwei People’s Hospital,Wuwei 733000,China)
出处 《临床肾脏病杂志》 2020年第7期608-611,共4页 Journal Of Clinical Nephrology
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