【摘要】 目的探讨原发性肾病综合征(primary nephrotic syndrome,PNS)并发急性肾功能衰竭(acute renal failure)的临床特点、治疗方法、预后。方法回顾分析2004年7月～2010年10月我科收治的原发性肾病综合征并发急性肾功能衰竭患者45例的临床资料。结果原发性肾病综合征并发急性肾功能衰竭的发生率为3.4%(45/1239),并发急性肾功能衰竭前后24h尿蛋白定量、血清甘油三酯、血清总胆固醇与入院时比较差异无统计学意义(P>0.05),而血清总蛋白、白蛋白、血钾、动脉血pH与入院时比较差异有统计学意义(P<0.05),血清尿素氮、肌酐差异有高度统计学意义(P<0.01)。对患者采用糖皮质激素或伴随使用环磷酰胺,利尿,减少尿蛋白,纠正电解质和酸碱平衡紊乱,抗凝及其他对症支持治疗等。41例(91.1%)患者治愈出院,3例(6.7%)患者逐渐发展为慢性肾功能衰竭,1例(2.2%)死于严重肺部肺炎克雷伯菌感染。结论原发性肾病综合征患者应定期复查肾功能,以期尽早发现并发急性肾功能衰竭的可能,早期的合理治疗有利于肾功能的恢复。更多还原

【Abstract】 Objective To investigate the primary nephrotic syndrome(primary nephrotic syndrome,PNS)with acute renal failure(acute renal failure)the clinical features,treatment,prognosis.Methods We reviewed the nephrotic syndrome and acute renal failure clinical data of 45 patients in our hospital from July 2004 to October 2010.Results The primary nephrotic syndrome and acute renal failure incidence rate was 3.4%(45/1239),acute renal failure before and after 24h urinary protein,serum triglycerides,serum total cholesterol were no statistical difference compared with the time of admission(P>0.05),while serum total protein,albumin,serum potassium,blood pH compared with the admission were significant difference(P<0.05),the difference of serum urea nitrogen,creatinine the difference had highly statistically significant(P<0.01).Patients with glucocorticoids or with cyclophosphamide,diuretic,reduce urinary protein,correct electrolyte and acid-base balance disorders,anticoagulant and other symptomatic and supportive treatment.41 cases(91.1%)recovered,3 cases(6.7%) evolved to chronic renal failure;1 case(2.2%)died from severe pulmonary Klebsiella pneumoniae infection.Conclusion The primary nephrotic syndrome of renal function should be regularly reviewed to early detection of acute renal failure,the possibility of rational therapeutic benefit of early renal function recovery.更多还原