血栓性微血管病：急性胰腺炎患者急性肾衰竭的非典型病因。
Thrombotic microangiopathy: an atypical cause of acute renal failure in patients with acute pancreatitis.
作者信息
Boyer Alexandre, Chadda Karim, Salah Amar, Bonmarchand Guy
机构信息
Service de Réanimation Médicale, Hôpital Charles Nicolle, Centre Hospitalier Universitaire de Rouen, 1 rue de Germont, 76031 Rouen, France.
出版信息
Intensive Care Med. 2004 Jun;30(6):1235-9. doi: 10.1007/s00134-004-2272-y. Epub 2004 Apr 7.
OBJECTIVE
To report on the development and treatment of thrombotic microangiopathy, an atypical cause of acute renal failure in patients with acute pancreatitis.
DESIGN
Case reports.
SETTING
A 21-bed medical intensive care unit at an university hospital.
PATIENTS
Two men with acute pancreatitis presented with acute renal failure, neurological manifestations, haemolytic anaemia and thrombocytopenia. Both patients required intensive care.
MEASUREMENTS
Fragmented red cell count; levels of haptoglobin, amylase and lipase; serological testing for Escherichia Coli O157; computed tomography of the abdomen.
MAIN RESULTS
The patients' courses were rapidly favourable after daily plasma exchange. A review of the existing medical literature was also undertaken.
CONCLUSION
As thrombotic microangiopathy may be life-threatening without administration of fresh frozen plasma or plasma exchange, physicians should consider this disease as a possible cause of acute renal failure in patients with acute pancreatitis.
目的
报告血栓性微血管病的发生及治疗情况，其为急性胰腺炎患者急性肾衰竭的非典型病因。
设计
病例报告。
地点
一所大学医院设有21张床位的医学重症监护病房。
患者
两名急性胰腺炎男性患者出现急性肾衰竭、神经学表现、溶血性贫血及血小板减少。两名患者均需要重症监护。
测量指标
破碎红细胞计数；触珠蛋白、淀粉酶及脂肪酶水平；大肠杆菌O157血清学检测；腹部计算机断层扫描。
主要结果
每日进行血浆置换后，患者病情迅速好转。同时对现有医学文献进行了回顾。
结论
由于血栓性微血管病若不给予新鲜冷冻血浆或进行血浆置换可能危及生命，医生应将该病视为急性胰腺炎患者急性肾衰竭的可能病因。
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