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目的 :探讨原发性肾病综合征 (PNS)并发急性肾功能衰竭 (ARF)的临床特点、肾脏病理特征、治疗方法和预后情况。方法 :回顾分析本院近 10年间 2 4例PNS并发ARF患者的临床特征、实验室检查、肾活检病理结果、治疗方法及预后情况。结果 :ARF多发生于肾病活动期早期或激素减药期 ,多以感染为诱因 ,占 66 67% ,大多数表现为少尿型肾衰 ,占 79 1% ,病理类型以轻微病变为主 ,占 61 1%。经治疗后 2 2例肾功能恢复正常 ,占79 1% ,PNS 15例完全缓解 ,4例部分缓解 ,5例无效。发现肾病到肾衰发生的平均时间为 ( 4 6± 2 4)d ,从肾衰发生到临床恢复的平均病程为 ( 5 7± 3 1)d。结论 :PNS合并ARF易发生于肾小球病变轻微患者 ,绝大多数患者ARF是可逆的 ,及时发现并予正确治疗 ,预后较好
Objective: To investigate the clinical features, renal pathological features, treatment and prognosis of patients with primary nephrotic syndrome (PNS) complicated with acute renal failure (ARF). Methods: A retrospective analysis of the hospital in the past 10 years 24 cases of PNS complicated with ARF patients with clinical features, laboratory tests, pathological results of renal biopsy, treatment and prognosis. Results: ARF occurred mostly in the active stage of nephropathy or the period of hormonal abstinence. Most of the patients were infected with infection, accounting for 66.67%, most of them showed oliguric renal failure, accounting for 79.1%. The pathological types were mainly minor, 61 1%. After treatment, 22 cases of renal function returned to normal, accounting for 79 1%, 15 cases of PNS complete remission, partial remission in 4 cases, 5 cases ineffective. The average time from nephropathy to renal failure was (46 ± 2 4) days. The average course of disease from renal failure to clinical recovery was (57 ± 31) days. Conclusion: PNS with ARF is easy to occur in patients with mild glomerular lesions, the vast majority of patients with ARF is reversible, timely detection and correct treatment, the prognosis is good