CAJ | 학술논문

目的：分析比较Bartter综合征（BS）和Gitelman综合征（GS）的临床及实验室特点，以提高诊治水平。方法回顾性收集BS（n＝15）和GS（n＝11）患者共26例。结果 BS多表现不同程度的乏力或双下肢乏力（14/15），GS常表现乏力并伴肢端麻木或抽搐；我们的资料表明BS较GS有更严重的低血钾（P＜0.05）；而GS血镁低、尿钙尿肌酐比值明显下降；两组肾素活性、血醛固酮水平无明显差异；两组经补钾或联合吲哚美辛、螺内酯等药物治疗后血钾均可上升；随访患者均仅长期补钾治疗，症状消失，血钾均未恢复正常。结论与BS相比，GS更常表现肢端麻木或抽搐，低血钾程度轻，而尿钙尿肌酐比值明显下降；单纯长期补钾治疗可消除症状，但不能达到治疗目标。
목적：분석비교Bartter종합정（BS）화Gitelman종합정（GS）적림상급실험실특점，이제고진치수평。방법회고성수집BS（n＝15）화GS（n＝11）환자공26례。결과 BS다표현불동정도적핍력혹쌍하지핍력（14/15），GS상표현핍력병반지단마목혹추휵；아문적자료표명BS교GS유경엄중적저혈갑（P＜0.05）；이GS혈미저、뇨개뇨기항비치명현하강；량조신소활성、혈철고동수평무명현차이；량조경보갑혹연합신타미신、라내지등약물치료후혈갑균가상승；수방환자균부장기보갑치료，증상소실，혈갑균미회복정상。결론여BS상비，GS경상표현지단마목혹추휵，저혈갑정도경，이뇨개뇨기항비치명현하강；단순장기보갑치료가소제증상，단불능체도치료목표。
Objective To analyze and compare the clinical and laboratory characteristics of Bartter syndrome (BS) and Gitelman syndrome (GS) for further improvement of diagnosis and treatment. Method Clinic data of 15 BS and 11 GS were collected. Results Fourteen in 15 patients with BS experienced different degrees of fatigue or lower limb weakness. While GS had varying degrees of weakness, but generally accompanied by numbness or twitching of limbs. Patients with BS may complicated with more severe hypokalemia than GS(P<0.05). While the serum magnesium and the ratio of urinary calcium and urinary creatinine decreased significantly. The based plasma renin activity and based aldosterone were markedly elevated in both groups, while there was no statistical significance. The symptoms of BS or GS patients were relieved by supplementation with potassium alone or in combination with indomethacin, spironolactone, but lower than the normal level. Conclusion Compared with BS, the patients with GS experienced more limb numbness or twitching, and light low blood potassium levels, but the ratio of urinary calcium and urinary creatinine decreased significantly;long-term supplement with potassium alone can eliminate symptoms, but do not meet treatment goal.