Björck S, Svalander C T, Aurell M
Department of Nephrology, University of Göteborg, Sahlgrenska Hospital, Sweden.
Nephron. 1988;49(1):45-53. doi: 10.1159/000184985.
Seven patients with acute renal failure after ingestion of analgesic drug combinations including paracetamol were seen. They presented with oliguric renal failure and restitution of renal function was complete. Only 2 patients had severe liver damage and 2 patients had no signs of liver abnormality. Renal biopsies, studied by light and electron microscopy, in 3 patients showed focal tubular epithelial cell necrosis. Focal vascular damage, predominantly of endothelial cells, was also present in all specimens. This vascular injury was found in various locations in the kidney, including the glomerular and peritubular capillaries and small arterioles. This suggests that microvascular damage is an important mechanism for the renal injury after analgesic drugs.
我们观察到7例在摄入含对乙酰氨基酚的复合镇痛药后出现急性肾衰竭的患者。他们表现为少尿性肾衰竭，且肾功能完全恢复。仅2例患者有严重肝损伤，2例患者无肝脏异常迹象。对3例患者进行的肾活检，经光镜和电镜研究显示局灶性肾小管上皮细胞坏死。所有标本中也均存在以血管内皮细胞为主的局灶性血管损伤。这种血管损伤见于肾脏的不同部位，包括肾小球和肾小管周围毛细血管以及小动脉。这表明微血管损伤是镇痛药导致肾损伤的重要机制。
