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[弥漫性肾脏病变与泌尿系统其他器官不同疾病的组合(诊断、病程特点及转归)]

[The combination of diffuse kidney lesions with different diseases of the other organs of the urinary system (the diagnosis, characteristics of the course and outcomes)].

作者信息

Shpigel' A N

出版信息

Ter Arkh. 1990;62(6):12-7.

PMID:2218908
Abstract

The author characterizes in detail 4340 patients with diffuse renal lesions (chronic glomerulonephritis, renal amyloidosis, lupoid nephritis, diabetic glomerulosclerosis and nephrosclerosis) coupled with different diseases of the urinary organs including urolithiasis, cancerous and tuberculous processes, purulent diseases of the kidneys and prostatic lesions. Stage III chronic renal failure (CRF) was revealed in 2073 (57.1%) out of the 4340 patients. All of them died because of uremia. The mean lifespan of the patients was 1.6 +/- 0.1 yr. since manifestation of the concomitant process. The shortest times of CRF onset, the highest frequency of stage III CRF and the least lifespan were noted in patients with double association, particularly in those suffering from associated chronic glomerulonephritis with renal amyloidosis and urinary bladder cancer in the stage of compression with tumor of the intramural parts of the ureters, namely they were 0.6 +/- 0.1, 100% and 1.0 +/- 0.1 yr., respectively. The author holds that the main reason for such an abrupt CRF onset in patients with concomitant renal lesions of any type lies in simultaneous combined influence on the kidneys of absolutely different diseases bearing in mind their etiology and pathogenesis. Besides, according to the author's data, considerable influences on the times of CRF onset and rates of its progress are produced by both the course and stage (phase) of the development of each of the coexistent diseases. Attention is drawn to the necessity of early participation of urologists in the solution of the problems concerned with the policy of managing nephrological patients with diseases of other organs of the urinary system as well as with permanent dynamic follow-up of all the patients with concomitant processes, especially with double ones.

摘要

作者详细描述了4340例患有弥漫性肾脏病变(慢性肾小球肾炎、肾淀粉样变性、狼疮样肾炎、糖尿病肾小球硬化症和肾硬化症)并伴有不同泌尿系统疾病的患者,这些泌尿系统疾病包括尿路结石、癌性和结核性病变、肾脏化脓性疾病以及前列腺病变。在这4340例患者中,有2073例(57.1%)出现了III期慢性肾衰竭(CRF)。他们均死于尿毒症。自并发疾病出现以来,患者的平均寿命为1.6±0.1年。在患有双重关联疾病的患者中,尤其是那些患有慢性肾小球肾炎合并肾淀粉样变性以及输尿管壁内部肿瘤压迫期膀胱癌的患者,CRF发病时间最短、III期CRF发生率最高且寿命最短,分别为0.6±0.1年、100%和1.0±0.1年。作者认为,任何类型的并发肾脏病变患者出现如此突然的CRF发病的主要原因在于,考虑到其病因和发病机制,完全不同的疾病同时对肾脏产生了联合影响。此外,根据作者的数据,每种并存疾病的发展过程和阶段(时期)对CRF发病时间及其进展速度也有相当大的影响。需要注意的是,泌尿科医生有必要尽早参与解决与管理患有泌尿系统其他器官疾病的肾病患者的策略相关的问题,以及对所有患有并发疾病,尤其是双重并发疾病的患者进行持续动态随访。

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