Bartter综合征8例临床分析.doc

Bartter综合征8例临床分析
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【摘要】目的探讨Bartter综合征的临床诊断及治疗。方法对8例成人Bartter综合征的临床资料进行回顾性分析。结果 8例成人 Bartter综合征患者均表现为乏力,其特征为低血钾,代谢性碱中毒,血清肾素活性、血管紧张素Ⅱ及醛固酮水平升高,而血压正常,肾活检提示肾小球旁器细胞增生。补钾是主要治疗措施。结论成人出现双下肢乏力,低血钾,高尿钾而血压正常时需考虑到本病,行醛固酮检测可帮助诊断,必要时行肾穿刺活检。治疗上包括补钾、补镁、醛固酮拮抗剂、前列腺素合成酶抑制剂等。
【关键词】成人 Bartter综合征诊断治疗
【Abstract】 Objective To investigate the clinical diagnosis and therapy of Bartter′s syndrome . Methods 8 cases of Bartter′s syndrome in adults were retrospectively analyzed. Results mon manifestation of eight cases of Bartter′s syndrome was fatigue. Bartter′s syndrome was characteristic of hypokalemia, metabolic alkalosis, elevations of plasma renin activity, serum angiotersin Ⅱand aldosterone and juxtaglomerular apparatus hyperplasia. Supplementation of potassium chloride was mainly the therapeutic measure. Conclusions Bartter′s syndrome should be suspected in adults with fatigue of low extremities , hypokalemia, hyperkaleura, and normal blood pressure. Aldosterone detection could help diagnosis, kidney biopsy if necessary. The therapy includes potassium supplementation ,magnesium supplementation, aldosteron antagonist, prostaglandin E synthase inhibitor,etc.

【Key words】 Bartter′s syndrome Diagnosis Therapy
Bartter综合征是1962年由Bartter首先报道的一组临床综合征。其临床特征是严重的低钾血症、代谢性碱中毒、肾素中等程度或明显增加,但是血压正常无水肿,肾活检显示肾小球旁细胞增生并肥大。作者对8例诊断为Bartter综合征住院病人的临床表现,实验室检查及治疗等进行了分析