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作者报告1例广泛主动脉粥样硬化患者因胆固醇微栓子引起坏死性肾小球肾炎。患者男性,75岁。因急性支气管炎入院。患者长期冠状动脉供血不足,近期有短时右侧偏盲。生化检查除血沉增快(72 mm/h)外无异常。血尿素及肌酐浓度正常,无蛋白尿,尿沉渣正常。经抗生素治疗后肺部症状改善。眼底检查发现右侧视网膜有3个胆周醇栓子。脑电子计算机体层描扫显示双侧缺血性损伤。主动脉有严重的动脉粥样硬化损伤,造影后36天发生少尿、迅速出现肾功能衰竭。血尿素氮91mg%,血肌酐4.6mg%,尿沉渣红细胞卅,有短时镜下血尿,尿蛋白1.5g/24五。2天后无尿而开始血液透析。
The authors report a case of extensive aortic atherosclerosis due to cholesterol microemboli cause necrotic glomerulonephritis. Male patient, 75 years old. Admitted to hospital due to acute bronchitis. Long-term coronary insufficiency in patients with recent short-term right hemianopia. Biochemical tests in addition to faster (72 mm / h) no exception. Normal blood urea and creatinine concentrations, proteinuria, urinary sediment normal. After antibiotic treatment of lung symptoms improved. Fundus examination found that the right side of the retina has three gallbladder alcohol embolus. Brain computed tomography showed bilateral ischemic injury. The aorta has severe atherosclerotic lesions, oliguria 36 days after angiography, rapid renal failure. Blood urea nitrogen 91mg%, serum creatinine 4.6mg%, urinary sediment erythrocyte 卅, a short time microscopic hematuria, urinary protein 1.5g / 24 five. Hemodialysis was started after 2 days without urine.