脂蛋白肾病一例并文献复习
摘要
<正>患者,女,32岁,因"浮肿伴蛋白尿2个月,加重10 d"于2016年1月13日入院。患者于2015年10月受凉后出现双下肢凹陷性水肿,当地医院查24 h尿蛋白5.233 g,血浆白蛋白25.6 g/L,诊断为"肾病综合征",先后予强的松60 mg/d、雷公藤多甙20 mg/d两次口服等治疗2个月,症状仍无缓解,为求进一步诊治收住入院。入院后体查:血压:141/103mmHg(1 mmHg=0.133 kPa),满月面容,眼睑轻度浮肿,无面部红斑及口腔溃疡,无黄色瘤及弓状角膜,心、肺、腹部无异常,双下肢凹陷性浮肿。实验室检查:血常规:血红蛋白97 g/L,白细胞11.87×10~(12)/L,红细胞3.2×10~9/L,血小板164×10~9/L,中性粒细胞比值0.80;尿沉渣:尿蛋白定性2+,尿隐血+,红细胞总数27.8/μl,白细胞总数48.1/μl,镜检
引文
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[6]解放军肾脏病研究所学术委员会.全血脂蛋白吸附治疗脂蛋白肾病[J].肾脏病与透析肾移植杂志,2004,13(5):493-498.DOI:10.3969/j.issn.1006-298X.2004.05.024.
[7]占锦峰,刘志红,李世军,等.免疫吸附治疗脂蛋白肾病的疗效观察[J].肾脏病与透析肾移植杂志,2006,15(3):203-209.DOI:10.3969/j.issn.1006-298X.2006.03.001.
[2]Ishigaki Y,Oikawa S,Suzuki T,etal.Virus-mediated transduction of apolipoprotein E(ApoE)-sendai develops lipoprotein glomerulopathy in ApoE-deficient mice[J].J Biol Chem,2000,275(40):31269-31273.DOI:10.1074/jbc.M005906200.
[3]Wu Y,Chen X,Yang Y,etal.A case of lipoprotein glomerulopathy with thrombotic microangiopathy due to malignant hypertension[J].BMC Nephrol,2013,14(1):53.DOI:10.1186/1471-2369-14-53.
[4]陈惠萍,刘志红,龚如军,等.脂蛋白肾病患者的临床表现及病理学特征[J].中华肾脏病杂志,2002,18(6):403-407.DOI:10.3760/j.issn:1001-7097.2002.06.004.
[5]Arai T,Yamashita S,Yamane M,etal.Disappearance of intraglomerular lipoprotein thrombi and marked improvement of nephrotic syndrome by bezafibrate treatment in a patient with lipoprotein glomerulopathy[J].Atherosclerosis,2003,169(2):293-299.
[6]解放军肾脏病研究所学术委员会.全血脂蛋白吸附治疗脂蛋白肾病[J].肾脏病与透析肾移植杂志,2004,13(5):493-498.DOI:10.3969/j.issn.1006-298X.2004.05.024.
[7]占锦峰,刘志红,李世军,等.免疫吸附治疗脂蛋白肾病的疗效观察[J].肾脏病与透析肾移植杂志,2006,15(3):203-209.DOI:10.3969/j.issn.1006-298X.2006.03.001.