Nielsen J D, Christensen L
Medicinsk afdeling C, Esbjerg Centralsygehus.
Ugeskr Laeger. 1992 Jan 6;154(2):72-4.
Infection in ventriculo-atrial shunts implanted for relief of raised intracranial pressure may, in rare cases, result in glomerulonephritis (shunt-nephritis). Most frequently, infection with low-virulent bacteria is concerned. This results in mild or subclinical symptoms with the subsequent risk that the condition is overlooked. The glomerular damage is considered to be precipitated by deposition of immune complexes in the kidneys and subsequent activation of the complement system. The renal manifestations consist of varying degrees of proteinuria, haematuria and reduction of renal function. Treatment consists of removal of the shunt. If continued relief of pressure in the ventricular system is necessary, a ventriculo-peritoneal shunt should be implanted. Normally, the prognosis of the renal disease is good. If the diagnosis and treatment are delayed, irreversible renal damage may result. Regular control of urine (proteinuria, haematuria) and blood (Hb, serumcreatinine and serum complement) are recommended in the follow up control of patients with ventriculo-atrial shunts.
为缓解颅内压升高而植入的脑室-心房分流管感染,在极少数情况下可能导致肾小球肾炎(分流性肾炎)。最常见的是低毒力细菌感染。这会导致轻微或亚临床症状,随后存在病情被忽视的风险。肾小球损伤被认为是由免疫复合物在肾脏沉积以及随后补体系统激活所引发的。肾脏表现包括不同程度的蛋白尿、血尿和肾功能减退。治疗包括移除分流管。如果需要持续缓解脑室系统压力,应植入脑室-腹腔分流管。通常,肾脏疾病的预后良好。如果诊断和治疗延迟,可能会导致不可逆转的肾脏损害。建议在对脑室-心房分流管患者进行随访时定期检查尿液(蛋白尿、血尿)和血液(血红蛋白、血清肌酐和血清补体)。