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目的:探讨注射用二磷酸果糖致急性高磷血症的临床特点及诱发急性肾功能衰竭的发病机理。方法:回顾性分析2003-2005年我院发生的5例二磷酸果糖致急性高磷血症患者临床资料。1例患者行肾组织病理学检查。结果:5例病人血磷均明显升高,达6.15～9.99mmol/L,临床出现急性肾功能衰竭或慢性肾功能不全急性加重及多系统损害。肾脏病理学检查显示急性肾小管间质性肾病,肾小管腔内及小血管壁钙化。结论:二磷酸果糖可引起严重急性高磷血症,导致多系统损害,以急性肾功能衰竭为突出表现。肾损伤的机制可能为急性肾钙质沉着。
Objective: To investigate the clinical characteristics of acute hyperphosphatemia induced by fructose diphosphate and the pathogenesis of acute renal failure. Methods: The clinical data of 5 patients with acute hyperphosphatemia induced by fructose diphosphate in our hospital from 2003 to 2005 were retrospectively analyzed. One patient underwent renal histopathology examination. Results: The phosphorus in all 5 patients was significantly increased, reaching 6.15 ~ 9.99 mmol / L. The clinical manifestations of acute renal failure or acute exacerbation of chronic renal insufficiency and multiple system damage. Renal pathological examination revealed acute tubulointerstitial nephropathy, renal tubular lumen and small vessel wall calcification. CONCLUSION: Fructose diphosphate can cause severe acute hyperphosphatemia resulting in multiple system damage, with acute renal failure as the most prominent manifestation. The mechanism of kidney damage may be acute renal calcinosis.