CAJ | 학술논문

目的探讨肾小球肾炎合并急性间质性肾炎(AIN)患者的临床和病理特点.方法回顾性分析21例经肾活检证实的肾小球肾炎合并AIN患者的资料,以同期无肾小球疾病的AIN患者35例作为对照.结果肾小球肾炎合并AIN占同期AIN的37 .5%.β内酰胺类抗生素、中药是引起AIN的主要病因.76 .2%的患者就诊原因为发现血肌酐升高.肾组织学检查同时存在.肾小球肾炎和AIN的病理改变,肾间质与肾小球病变程度不平行,前者普遍重于肾小球损害,肾间质中嗜酸性粒细胞对诊断有提示价值.随访中,64 .7%的患者肾功能最终恢复正常或基线水平,中位恢复时间为150 d(单纯AIN组为60 d),两组患者在2年内肾功能恢复情况方面无明显差异.结论肾小球肾炎合并AIN的患者临床表现不典型,AIN的症状易被肾小球肾炎掩盖.肾活检对诊断和鉴别有重要价值.早期诊治的患者预后较好.
목적 탐토신소구신염합병급성간질성신염(AIN)환자적림상화병리특점.방법 회고성분석21례경신활검증실적신소구신염합병AIN환자적자료,이동기무신소구질병적AIN환자35례작위대조.결과 신소구신염합병AIN점동기AIN적37 .5%.β내선알류항생소、중약시인기AIN적주요병인.76 .2%적환자취진원인위발현혈기항승고.신조직학검사동시존재.신소구신염화AIN적병리개변,신간질여신소구병변정도불평행,전자보편중우신소구손해,신간질중기산성립세포대진단유제시개치.수방중,64 .7%적환자신공능최종회복정상혹기선수평,중위회복시간위150 d(단순AIN조위60 d),량조환자재2년내신공능회복정황방면무명현차이.결론 신소구신염합병AIN적환자림상표현불전형,AIN적증상역피신소구신염엄개.신활검대진단화감별유중요개치.조기진치적환자예후교호.
Objective To identify the clinical characteristics and pathological changes of patients suffered from glomerulonephritis complicating with acute interstitial nephritis (AIN) . Methods Twenty one patients of glomerulonephritis complicating with AIN diagnosed by renal biopsy were retrospectively analyzed . Thirty-five pure AIN patients were selected as controls .Results Glomerulonephritis complicating AIN accounted for 37 .5% of all the AIN cases . Βlactam antibiotics and Chinese herbs were the major causes of AIN . 76 .2% of cases received further examinations due to the elevation of serum creatinine (Scr) during their follow-up of kidney injuries or during routine exams for all kinds of discomforts . Pathological features of AIN were also detected besides glomerular leisions . The impairments of renal interstitia were severe than those of the glomeruli . Eosinophil in the renal interstitia was an important indicator for the diagnosis of AIN .The renal function returned to normal or baseline in 64 .7% of the patients of glomerulonephritis complicating with AIN whose follow-up data were available . The median period for renal function restoration was 150 days (compared with 60 days in pure AIN) . But there were no significant differences between these two groups as for the rate of irreversible renal insufficiency during a follow-up period of 2 years . Conclusions Symptoms of AIN in patients of glomerulonephritis complicating with AIN tend to be masked by their glomerular diseases . Renal biopsy is of most importance for the diagnosis . Early diagnosis and treatment leads to satisfactory prognosis .