The clinical features of longer duration, there can be asymptomatic phase for some time, was slowly progressive course of the disease. Urinalysis with varying degrees of proteinuria, erythrocyte sediment microscopy can be seen, most patients have varying degrees of hypertension and renal dysfunction. Clinical manifestations of chronic nephritis is similar, but the pathological type and lesions of varying severity. According to most of the major glomerular lesions, divided into mesangial proliferative glomerulonephritis, membranous nephropathy, focal segmental glomerular sclerosis, mesangial capillary glomerulonephritis, proliferative glomerulosclerosis.
Most patients with chronic nephritis cause is unclear. After the delayed healing of acute streptococcal glomerulonephritis, duration of more than 1 year can be transferred to chronic nephritis. But most are not persistent from chronic nephritis from acute nephritis, generally due to the long-term effects and long-term immune mechanisms of renal hemodynamic changes, renal vascular changes, mesangial functional changes caused.
Previously generally believed that if acute glomerulonephritis proteinuria and microscopic hematuria continued for more than 6 months to 1 year already transferred to chronic renal biopsy and clinical data in recent years found that urinary abnormalities after acute nephritis and renal biopsy activity performance In 2 to 3 years of follow-up gradually disappear. So not a single time for the community to determine the distinction between acute or chronic glomerulonephritis. According to follow-up data found that the clinical manifestations of acute glomerulonephritis disappearance still have residual kidney disease, renal fibrosis, but sometimes, and sometimes urine routine examination still found in protein and red blood cells, and kidney biopsy found the diffuse inflammatory lesions have disappeared, only residual focal lesions, called "There defect healing." Some patients with follow-up time increases, the biopsy found there is a growing trend in glomerular fibrosis. In case of the above situation should continue to follow-up observation, attention to the possibility of whether the development of chronic glomerulonephritis.
Patients with acute exacerbation of chronic nephritis is also a tendency, in every case the disease is relatively stable, due to the sudden malignant respiratory infection or other stimuli, (3 to 5 days or even 1 to 2 days) disease abrupt deterioration in the short term, when patients proteinuria, or hematuria, tube increases. Worsening edema and hypertension, and renal function. After appropriate treatment, the condition can be alleviated, largely restored to its original level, and may therefore lead to disease progression into uremia.
Chronic glomerulonephritis with recurrent kidney stumped numerous experts, but also make a lot of patients with chronic nephritis upsetting. Treatment must first understand the disease, the cause of recurrent chronic glomerulonephritis lot, mainly from the following aspects analysis.
First, with its own type of chronic glomerulonephritis related pathology, such as certain types of pathology itself is irreversible, such as focal segmental glomerular sclerosis;
Secondly, and medication is reasonable or not, in particular in the rational use of hormones and cytotoxic drugs, antihypertensive drugs is important. Nephrotoxic drugs misuse, misuse is up aminoglycosides such as gentamicin, if the result in deterioration of renal function, causing uremia.
Third, some of the efficacy of the drug itself is not sure, such as dipyridamole and so reduce the role of protein in the urine, they often repeated ever after withdrawal. Patients often do not follow the doctor's advice, even stopping the drug itself increase or decrease, resulting in a rebound phenomenon.
Fourth, chronic glomerulonephritis immune function is low, particularly associated with anemia and hypoproteinemia who own constitution and resistance are low, intolerance fatigue, susceptibility to infection, once the life and work without the law, that is due to upper respiratory tract infections, especially infections, fatigue and other factors induced increase, or even manifestations of acute exacerbation of chronic nephritis, or cause deterioration of renal function.
Fifth, physical activity is a need to consume physical activity, and fatigue is leading to recurrent chronic glomerulonephritis, causing an important incentive for renal dysfunction or acute exacerbation of chronic nephritis. Thus, the first rehabilitation of chronic nephritis should prevent recurrent disease.
没有评论:
发表评论