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[肾综合征出血热病史患者的肾脏长期转归及慢性病形成情况]

[Long-term outcomes and formation of chronic disease of the kidneys in patients with a history of hemorrhagic fever with renal syndrome].

作者信息

Dudarev M V, Pimenov L T

出版信息

Ter Arkh. 2008;80(6):59-62.

Abstract

AIM

To evaluate renal function, persistence of renal dysfunction and probability of chronic renal pathology in convalescents of hemorrhagic fever with renal syndrome (HFRS).

MATERIAL AND METHODS

A total of 370 HFRS convalescents were examined with estimation of renal functional reserve, albuminuria, uric acid clearance, activity of urine N-acetil-beta-D-hexosaminidase in the urine, 18-h deprevation test, duplex scanning of renal vessels. Correlation between prevalence of chronic renal failure in Udmurtia and HFRS incidence was analysed.

RESULTS

Glomerular and tubular dysfunctions in HFRS convalescents (intraglomerular hypertension, albuminuria, regress of a concentration ability of the kidneys, impairment of tubular transport) are characterized by persistence in the presence of renal hypoperfusion and hypoexcretory hyperuricemia. 13% convalescents developed chronic disease of the kidneys (CDK) which clinically presented as chronic tubulointerstitial nephritis. HFRS may contribute to formation of population of patients with chronic renal failure in the territory of active natural foci. A significant positive correlation was registered between mean annual levels of HFRS morbidity and prevalence of chronic renal failure in different regions of Udmurtia. According to clinical data, chronic renal failure develops in patients who earlier have suffered from renal disease.

CONCLUSION

Persistance of renal dysfunctions in HFRS convalescents and possible onset of chronic disease of the kidneys necessitate active follow-up of the disease convalescents.

摘要

目的

评估肾综合征出血热(HFRS)恢复期患者的肾功能、肾功能障碍的持续情况以及慢性肾脏病变的发生概率。

材料与方法

对370例HFRS恢复期患者进行检查,评估其肾功能储备、蛋白尿、尿酸清除率、尿N-乙酰-β-D-氨基己糖苷酶活性、18小时禁水试验、肾血管双功扫描。分析乌德穆尔特地区慢性肾衰竭患病率与HFRS发病率之间的相关性。

结果

HFRS恢复期患者的肾小球和肾小管功能障碍(肾小球内高压、蛋白尿、肾脏浓缩能力减退、肾小管转运受损)表现为在存在肾灌注不足和排泄减少性高尿酸血症的情况下持续存在。13%的恢复期患者发展为慢性肾脏疾病(CDK),临床上表现为慢性肾小管间质性肾炎。HFRS可能促使活跃自然疫源地地区慢性肾衰竭患者群体的形成。在乌德穆尔特不同地区,HFRS年平均发病率与慢性肾衰竭患病率之间存在显著正相关。根据临床资料,慢性肾衰竭发生在先前患有肾脏疾病的患者中。

结论

HFRS恢复期患者肾功能障碍的持续存在以及可能发生的慢性肾脏疾病需要对该疾病恢复期患者进行积极随访。

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