Adams F G, Murray R M
Clin Radiol. 1975 Jul;26(3):417-27. doi: 10.1016/s0009-9260(75)80088-2.
A study was made of the radiological findings in 57 patients with a clinical diagnosis of analgesic nephropathy. The ages of the patients ranged from 27 to 72 years, and females predominated over males in the ratio 4-7 to 1. Renal failure varied from mild to very severe and the patients showed the usual high incidence of analgesic-induced gastro-intestinal, haematological and neurological disorders. In 82% of cases, kidneys were of normal size, but there was radiological evidence of reduced renal function in 85%. Thus, a small kidney with good renal function was unlikely to be due to analgesic nephropathy. Medullar necrosis was observed in 65%, and papillary atrophy and papillary necrosis each in 46%. Although usually gradual, acute massive sloughing of necrotic papillae could occur and occasionally led to ureteric obstruction. Papillary cavitation was seen in 39% but fistulae and ring shadows were observed in only 11% and 14% respectively, while renal calcification occurred in 26%. With the use of high dose techniques and retrograde pyelography, it is almost always possible to make a positive radiological diagnosis of analgesic nephropathy, even in patients with markedly reduced renal function.
对57例临床诊断为止痛剂肾病的患者的放射学检查结果进行了研究。患者年龄在27岁至72岁之间，女性与男性的比例为4.7比1，女性占优势。肾功能衰竭程度从轻度到极重度不等，患者显示出止痛剂引起的胃肠道、血液学和神经学疾病的常见高发病率。在82%的病例中，肾脏大小正常，但85%有肾功能减退的放射学证据。因此，肾功能良好的小肾脏不太可能是由止痛剂肾病引起的。观察到65%有髓质坏死，46%有乳头萎缩和乳头坏死。坏死乳头虽然通常是逐渐脱落，但也可能发生急性大量脱落，偶尔导致输尿管梗阻。39%可见乳头空洞形成，但分别只有11%和14%观察到瘘管和环形阴影，26%发生肾钙化。使用高剂量技术和逆行肾盂造影，即使在肾功能明显减退的患者中，几乎总能对止痛剂肾病作出阳性放射学诊断。
