ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2018, Vol. 27 ›› Issue (3): 294-299.DOI: 10.3969/j.issn.1006-298X.2018.03.021

• 论文 • 上一篇    

钙性尿毒症性小动脉病

  

  • 出版日期:2018-06-28 发布日期:2018-06-29

Calcific uremic arteriolopathy

  • Online:2018-06-28 Published:2018-06-29

摘要:

34岁男性患者,维持性血液透析治疗12年,继发性甲状旁腺功能亢进病史4年,半年前出现皮肤多发性溃疡灶、皮肤敏感及粗糙增厚等,其足趾自行坏死脱落,伴有剧痛。行甲状旁腺全切术后,全段甲状旁腺激素及钙磷紊乱好转,但疼痛加剧,肢端缺血坏死持续加重。诊断为钙性尿毒症性小动脉病,予硫代硫酸钠为主的综合治疗,疼痛明显减轻,其足部坏死仍持续进展,但全身病变得到控制,早期及中期病灶好转,呈愈合趋势。

关键词: 钙性尿毒症性小动脉病, 维持性血液透析, 血管钙化, 缺血性坏死

Abstract:

A 34yearold male patient with 12 years of maintenance hemodialysis therapy,he was diagnosed as secondary hyperparathyroidism for 4 yearsClinical manifestations including multiple skin ulcers,skin sensitivity and roughening were encontered six months agoThe toes were necrotic and fall off with severe painAfter resection of  parathyroid gland,iPTH、calcium and phosphorus disorders improved,but the pain increased,and ischemic necrosis continued to increaseCalcific uremic arteriolopathy was consideredSodium thiosulfatebased comprehensive treatment was adapted,and the analgesic effect was obviousThe foot necrosis continued to progress,but the systemic lesions were ameliorated,especially the early and midstage lesions,showing a healing tendency

Key words: calcific uremic arteriolopathy, maintenance hemodialysis, vascular calcification, ischemic necrosis