Yasuda G, Zierer R, Maio A, Shioniri H, Ishii M, Umemura S
Second Department of Internal Medicine, Yokohama City University School of Medicine, Japan.
Clin Investig. 1994 May;72(5):385-9. doi: 10.1007/BF00252833.
In two patients with Bartter's syndrome proximal tubular function and distal chloride reabsorption were intact on admission; however, chloride reabsorption and distal tubular acidifying capacity decreased in one patient over a period of 10 years. Renal prostaglandin E excretion and urinary and plasma uric acid were in the normal range, but urinary ammonium was significantly elevated during controlled diet. One patient developed ammonium urate nephrolithiasis. In both patients renal biopsy demonstrated lymphocytic infiltration of the interstitial tissue and hypercellularity of the macula densa. Indomethacin treatment improved serum potassium concentration and decreased plasma renin activity, plasma aldosterone concentration, and urinary prostaglandin E but had to be discontinued because of side effects. It is likely that our patients represent a variant form of the syndrome originally described by Bartter.
两名巴特综合征患者入院时近端肾小管功能和远端氯化物重吸收功能均正常；然而，其中一名患者在10年期间氯化物重吸收和远端肾小管酸化能力下降。肾前列腺素E排泄以及尿和血浆尿酸均在正常范围内，但在控制饮食期间尿铵显著升高。一名患者发生尿酸铵肾结石。两名患者的肾活检均显示间质组织淋巴细胞浸润和致密斑细胞增多。吲哚美辛治疗改善了血清钾浓度，降低了血浆肾素活性、血浆醛固酮浓度和尿前列腺素E，但因副作用不得不停药。我们的患者可能代表了最初由巴特描述的该综合征的一种变异形式。
