Brun P, Beaufils F, Pillion G, Schlegel N, Loirat C
Unité de Néphrologie, Hôpital Robert-Debré, Paris.
Ann Pediatr (Paris). 1993 Feb;40(2):75-80.
Thirty-nine neonates with renal vein thrombosis diagnosed in our hospital department between 1973 and 1991 were studied retrospectively. Twenty-five patients were and 14 were not treated with urokinase (UK). Among the five deaths (13%), four occurred at the acute stage from non-renal complications and one occurred at the age of three months from end-stage renal failure. Eight patients (21%) have moderate renal failure after a mean follow-up of 7.4 years; a single patient (2%) developed end-stage renal failure after 7.9 years and 25 patients (64%) have a normal glomerular filtration rate after a mean follow-up of 4.5 years. Rates of death and chronic renal failure were 8% and 32%, respectively, in the group given UK and 21% and 7%, respectively, in the group not given UK. Among 54 involved kidneys, only 10 (19%) recovered normal function and morphological features. Functional impairment was seen in 11 of 37 (30%) kidneys treated by UK and 10 of 17 (59%) kidneys not treated by UK. Although these data suggest that UK may be effective in promoting recanalization of renal veins obstructed by thrombosis, confirmatory evidence could be obtained only by performing a prospective therapeutic trial.
对1973年至1991年间在我院确诊为肾静脉血栓形成的39例新生儿进行回顾性研究。25例患者接受了尿激酶（UK）治疗，14例未接受治疗。在5例死亡病例（13%）中，4例死于急性期的非肾脏并发症，1例在3个月时死于终末期肾衰竭。平均随访7.4年后，8例患者（21%）出现中度肾衰竭；1例患者（2%）在7.9年后发展为终末期肾衰竭，25例患者（64%）在平均随访4.5年后肾小球滤过率正常。接受UK治疗组的死亡率和慢性肾衰竭发生率分别为8%和32%，未接受UK治疗组分别为21%和7%。在54个受累肾脏中，只有10个（19%）恢复了正常功能和形态特征。接受UK治疗的37个肾脏中有11个（30%）出现功能损害，未接受UK治疗的17个肾脏中有10个（59%）出现功能损害。尽管这些数据表明UK可能有效促进因血栓形成而阻塞的肾静脉再通，但只有通过进行前瞻性治疗试验才能获得确证性证据。
