【摘要】 <正> 自1962年Bartter氏首先报告了两例患者有肾小球旁器增生肥大,高血浆肾素活性、醛固酮分泌增多,低血钾,碱中毒,正常血压和血管壁对外源性血管紧张素Ⅱ不敏感的综合征以来,国内外不断有新病例报告发表。我院内分泌组1977至1978年观察到1例女青年患者,曾两次住院,经一再会诊,右肾部分切除。病理检查及各方面治疗观察,最后诊断为巴特氏综合征。目前患者病情稳定。已康复出院,生活如常人。更多还原

【Abstract】 This article reports and discusses a female patient, aged 24, with Bartter’s syndrome associated with hyperuricemia, nephrolithiasis and nephropyelitis. She was twice hospitalized during 1977-1978 and had nephrolithotomy in 1977. The histological examination of the kidney substantiated the diagnosis of interstitial nephritis and juxtaglomerular cell hyperplasia. After operation spironolactone and postassium chloride was given to her with satisfactory response. However, aspirin did not give sufficient improvement. One and a half year after discharge, she was in a good condition and the symptoms did not recur.As it is known, Bartter’s syndrome which is characterized by markedly elevated levels of plasma renin activity, hyperaldosteronism, hypokalemia, alkalosis, normal blood pressure, and juxtaglomerular cell hyperplasia, increased urinary prostaglandin E excretion, and marked resistance to pressor action of exogenous angiotensin Ⅱ.This disease may also be associated with loss of water and sodium chloride, renal disease and dysfunction, gout with or without arthritis, hyperuricemia, nephrolithiasis and so on. The clinical findings of Bartter’s syndrome is strongly similar to primary hyperaldosteronism except for hypertension.It is customary to treat the patient mainly with a prostaglandin synthetase inhibitor-indomethacin or aspirin, besides, antialdosterone medicine-spironolactone. and hyperrenin activity inhibitor-propranolol obtained a good effect. Administration of potassium chloride only is often without response. So it is advisable to give combined therapy.更多还原