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中华肾病研究电子杂志 ›› 2023, Vol. 12 ›› Issue (06) : 354 -356. doi: 10.3877/cma.j.issn.2095-3216.2023.06.010

病例报告

肝移植术后出现肾病综合征伴急性肾损伤:一例临床分析
王柳西, 王婧, 赖佳美, 任咪咪, 赵云凤, 罗婧, 远航()   
  1. 130012 长春,吉林大学第一医院肾病科
    210009 南京,东南大学附属中大医院肾脏内科
  • 收稿日期:2022-08-16 出版日期:2023-12-28
  • 通信作者: 远航
  • 基金资助:
    吉林省教育厅科研项目(JJKH20190025KJ); 吉林省科技厅科研项目(20180101109JC)

Clinical analysis of nephrotic syndrome with acute kidney injury after liver transplantation: a case report

Liuxi Wang, Jing Wang, Jiamei Lai   

  • Received:2022-08-16 Published:2023-12-28
引用本文:

王柳西, 王婧, 赖佳美, 任咪咪, 赵云凤, 罗婧, 远航. 肝移植术后出现肾病综合征伴急性肾损伤:一例临床分析[J/OL]. 中华肾病研究电子杂志, 2023, 12(06): 354-356.

Liuxi Wang, Jing Wang, Jiamei Lai. Clinical analysis of nephrotic syndrome with acute kidney injury after liver transplantation: a case report[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2023, 12(06): 354-356.

微小病变型肾病(minimal change disease,MCD)是足细胞病的一种,以肾病综合征为主要临床表现。糖皮质激素是治疗MCD的首选,大部分患者对激素治疗敏感,但易于复发。对于频繁复发的MCD患者,可以联用烷基化剂、钙调磷酸酶抑制剂(calcineurin inhibitor,CNIs)、霉酚酸酯等免疫抑制剂。本文报道了一例肝移植术后的患者,在长期应用免疫抑制剂的前提下出现了MCD,在激素联合CNIs、麦考酚钠免疫抑制治疗中,激素减量时出现了MCD复发,提示传统的CNIs类药物及麦考酚钠等免疫抑制剂并不是防治MCD复发的关键,激素在MCD的治疗中具有关键作用。

图1 患者肾脏病理改变注:A:HE染色×400; B:IgA荧光染色×400; C:电镜×6000
图2 患者治疗方案及相关指标变化
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