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Bartter综合征是由肾小球旁细胞增生,分泌大量肾素,继发醛固酮增多,临床上以低血钾性碱中毒,血压正常,而对外源性血管加压素反应低下为特点的一种疾病。临床罕见.现将我们诊治的一例肝硬化合并Bartter综合征的患者报告如下.患者,女,58岁,家务,因腹胀、恶心、呕吐,不能进食50天,双下肢瘫痪,间断性抽搐半个月,于1992—10—16入院。既往慢性肝病病史10余年.体检:体温35.8℃,脉搏88次/分,血压15.0/9.0kPa,急性病容,肝掌(+),心肺正常.腹呈蛙型,肝脾未触及,移动性浊音(+),双下肢肌力Ⅰ级,肌张力减低,双下肢跖反射消失,肛门反射消失,病理反射未引出,辅助检查:乙肝系列:HBsAg≥8.00,抗HBs0.71,HBeAg4.07,抗HBe≥8.00,抗HBc(总)1.00;肝功系列:ALT16IV/L,AST 44Ⅳ/L.
Bartter syndrome is characterized by hyperplasia of proximal glomerular cells, the secretion of large amounts of renin, secondary aldosterone increased, clinical hypokalemic alkalosis, normal blood pressure, and low response to exogenous vasopressin disease. Clinically, we now report a diagnosis of patients with cirrhosis and Bartter syndrome patients are as follows.Patients, female, 58 years old, housework, due to abdominal distension, nausea, vomiting, can not eat 50 days, both lower limb paralysis, intermittent seizures half Month, admitted to hospital on October 10, 1992. Past history of chronic liver disease more than 10 years.Physiological examination: body temperature 35.8 ℃, pulse 88 beats / min, blood pressure 15.0 / 9.0kPa, acute disease, liver palms (+), normal heart and lung .Frontal was frog type, liver and spleen not touched, (+), Lower extremity muscle strength Ⅰ, muscle tension decreased, both lower extremities plantar reflex, anal reflex disappeared, pathological reflex did not lead to help check: Hepatitis B series: HBsAg ≥ 8.00, anti-HBs0.71, HBeAg4.07, anti HBe≥8.00, anti-HBc (total) 1.00; liver function series: ALT16IV / L, AST44Ⅳ / L.