CAJ | 학술논문

目的总结5例药物致假性巴特综合征的临床特点和治疗转归,探讨发病机制.方法回顾性分析天津医科大学总医院内分泌科2008年5月至2010年12月5例药物致假性巴特综合征患者病历资料.结果患者均为中青年女性,有长期服用泻剂和利尿剂史.临床上以正常血压、低钾代谢性碱中毒、肾素-血管紧张素-醛同酮系统的激活为特点.3例患者肾穿刺病理活检均可见球旁器增生,小动脉管壁增厚.间质可见淋巴、单核细胞浸润.肾小管可见不同程度的退行性变.早期诊断,及时停用致病性药物配合补充氯化钾治疗.实验室检查在4周内恢复正常范围.结论临床合理应用利尿剂和泻剂可减少假性巴特综合征的发生.
목적 총결5례약물치가성파특종합정적림상특점화치료전귀,탐토발병궤제.방법 회고성분석천진의과대학총의원내분비과2008년5월지2010년12월5례약물치가성파특종합정환자병력자료.결과 환자균위중청년녀성,유장기복용사제화이뇨제사.림상상이정상혈압、저갑대사성감중독、신소-혈관긴장소-철동동계통적격활위특점.3례환자신천자병리활검균가견구방기증생,소동맥관벽증후.간질가견림파、단핵세포침윤.신소관가견불동정도적퇴행성변.조기진단,급시정용치병성약물배합보충록화갑치료.실험실검사재4주내회복정상범위.결론 림상합리응용이뇨제화사제가감소가성파특종합정적발생.
Objective To summarize the clinical characteristics and outcomes of Pseudo-Bartter's syndrome and explore its pathogenesis.Methods The clinical data of 5 cases of Pseudo-Bartter's syndrome at our ward from May 2008 to December 2010 was analyzed retrospectively.Results All patients were female. Long-term regimen of purgative or diuretics was prescribed. The clinical features included normotension,hypokalemic alkalosis and activation of renin-angiotensin-aldosterone.The pathological results of 3 cases of kidney biopsy showed the hyperplasia of juxtaglomerular apparatus,thickness of arteriole,infiltration of lymphocytes and monocytes and degeneration of renal tubule. Upon a definitive diagnosis,purgative or diuretics was discontinued and supplement therapy of potassium chloride initiated.The results of laboratory tests reverted to normal ranges within 4 weeks.Conclusion Purgative or diuretics should be prescribed appropriately to avoid the occurrence of Pseudo-Bartter's syndrome.