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目的和方法 从临床角度分析了１１５ 例肾小管性酸中毒（ Ｒ Ｔ Ａ） 的病因、发病率及有关化验、治疗方法。结果和结论 （１） 原发性 Ｒ Ｔ Ａ 占２３ ．５ ％ ，继发性 Ｒ Ｔ Ａ 占７６ ．５ ％ ，误诊率为３３ ％ ，要引起临床高度重视。（２） 免疫性疾病伴发 Ｒ Ｔ Ａ 明显增多，占２７ ．８ ％ 。（３） 临床分型： Ｉ型最常见为７１ ％ ， Ｉ Ｉ型１４ ％ ， Ｉ Ｉ Ｉ型７ ％ ， Ｉ Ｖ 型为８ ％ 。（４） 尿酸化试验是诊断 Ｒ Ｔ Ａ 首选的筛选试验，治疗后数年仍阳性。４０／１１５ 例是通过检查该化验发现 Ｒ Ｔ Ａ 的。其它如微量蛋白、 Ｔａｍ ｍ Ｈｏｒｓｆａｌｌ 糖蛋白（ Ｔ Ｈ Ｐ）均能反映小管间质损害。抗肾集合管抗体（ ＋ ） 提示免疫性疾病。（５） 枸橼酸合剂、钙及维生素 Ｄ 制剂治疗要循序渐进，可以减少不必要的副作用。
OBJECTIVE AND METHODS One hundred and fifteen patients with renal tubular acidosis (R T A) were analyzed from the clinical point of view for the etiology, incidence and related laboratory tests and treatments. Results and Conclusions (1) Primary R T A accounted for 23%. 5%, secondary R T A accounted for 76%. 5%, the misdiagnosis rate is 33%, to cause clinical attention. (2) The immune disease accompanied with R T A obviously increased, accounting for 27. 8%. (3) Clinical classification: the most common type I was 71%, type I 14%, type I I 7%, type I 8%. (4) uric acid test is the first choice of screening R T A screening test, a few years after treatment is still positive. 40/115 cases were found by examining this assay R T A. Other trace protein, Tam m Horsfall glycoprotein (T H P) can reflect the tubulointerstitial damage. Anti-renal tube antibodies (+) suggest immune disease. (5) Citric acid mixture, calcium and vitamin D preparations to be gradual, can reduce unnecessary side effects.