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目的 :研究中药木通中毒性肾损害的临床特点 ,探讨其与马兜铃酸肾病的联系。方法 :通过3例木通中毒致肾损害的临床病理改变 ,复习文献 ,综合分析木通中毒性肾损害的临床特点 ,与马兜铃酸肾病作比较。结果 :3例患者均因服用含有大剂量关木通的“排石”汤后发生肾损害。其中 2例呈非少尿型急性肾衰 ,需血液透析。另 1例呈肾小管性酸中毒 ,肾功能损害较轻 ,Scr1 32 μmol/ L,在停药 3个月后肾活检诊断为急性肾小管坏死。随访 8个月～ 1年 ,3例均演变为慢性肾功能不全。集文献分析 ,显示木通中毒性肾损害的临床特点为 :1临床表现轻重不等 ,与药物中毒剂量大小有关。 2常有多种肾小管功能障碍。 3常呈持续性肾功能损害。结论 :木通中毒致肾损害的临床表现有一定特点。木通中毒性肾损害的临床特点与马兜铃酸肾病相似。两者是否属同一种病值得进一步研究
Objective: To investigate the clinical features of Chinese traditional medicine Komto toxic nephropathy and to explore its relationship with aristolochic nephropathy. Methods: Through the clinical pathological changes of renal damage induced by three strains of Tong Tong, review the literature, comprehensive analysis of the clinical features of Tong Tong toxic kidney damage compared with aristolochic nephropathy. Results: All three patients developed renal damage after taking “Pai Shi” soup containing large doses of Guantong. Two of them were non-oliguric acute renal failure requiring hemodialysis. Another case was renal tubular acidosis, renal damage less, Scr1 32 μmol / L, 3 months after stopping the renal biopsy diagnosed as acute tubular necrosis. All patients were followed up for 8 months to 1 year. All of the 3 patients developed chronic renal insufficiency. Set of literature analysis, shows the clinical features of Komto toxic kidney damage as follows: 1 clinical manifestations ranging from the severity of drug poisoning dose. 2 often a variety of renal tubular dysfunction. 3 often showed persistent renal damage. Conclusion: The clinical manifestations of renal damage caused by the wood poisoning have certain characteristics. Ketong toxic kidney damage clinical features and aristolochic acid nephropathy similar. Whether the two belong to the same kind of disease deserves further study