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慢性乳糜尿:3例患者的临床研究

Chronic chyluria: a clinical study of 3 patients.

作者信息

Ciferri F, Glovsky M M

出版信息

J Urol. 1985 Apr;133(4):631-4. doi: 10.1016/s0022-5347(17)49119-1.

Abstract

Studies of patients with chyluria or chylothorax have demonstrated significant disruptions of protein, blood and fat metabolism that may result in iron deficiency anemia, hypoproteinemia, hypolipidemia and malnutrition. To document the sequential development of these complications we performed serial clinical and biochemical studies for 2 to 12 years in 3 patients with presumed filarial chyluria whose sole treatment had been diethylcarbamazine. Despite the chronic loss of chyle in the urine these 3 patients did not have significant complications during the period of observation. The weight and blood pressure remained stable. No persistent anemia, hypoproteinemia or hypolipidemia was noted. Except for 1 patient in whom a transient decrease of the creatinine clearance developed during pregnancy, no permanent renal function impairment occurred. These observations suggest that chronic chyluria may not always result in serious alterations of the physical status or body functions of these patients requiring surgical repair, and supports the hypothesis that untreated chyluria could be a relatively benign process in our milieu.

摘要

对乳糜尿或乳糜胸患者的研究表明,蛋白质、血液和脂肪代谢存在显著紊乱,可能导致缺铁性贫血、低蛋白血症、低脂血症和营养不良。为了记录这些并发症的相继发展过程,我们对3例疑似丝虫性乳糜尿患者进行了为期2至12年的系列临床和生化研究,这些患者仅接受过乙胺嗪治疗。尽管这3例患者长期尿中丢失乳糜,但在观察期间并未出现明显并发症。体重和血压保持稳定。未发现持续性贫血、低蛋白血症或低脂血症。除1例患者在妊娠期间肌酐清除率短暂下降外,未发生永久性肾功能损害。这些观察结果表明,慢性乳糜尿不一定总会导致这些患者身体状况或身体功能的严重改变而需要手术修复,这支持了在我们的环境中未经治疗的乳糜尿可能是一个相对良性过程的假说。

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