Bartter综合征和Gitelman综合征临床分析_阳池娇.pdfVIP

中华临床医师杂志( 电子版)2013 年9 月第7 卷第18 期 Chin J Clinicians(Electronic Edition),September 15,2013,Vol.7,No.18 ·8257 · ·临床论著· Bartter 综合征和Gitelman 综合征临床分析 阳池娇 曹筱佩 符娟 肖海鹏 廖志红 李延兵 【摘要】 目的 分析比较Bartter 综合征（BS ）和Gitelman 综合征（GS ）的临床及实验室特点，以提 高诊治水平。方法 回顾性收集BS （n ＝15）和GS （n ＝11）患者共26 例。结果 BS 多表现不同程度的 乏力或双下肢乏力（14/15），GS 常表现乏力并伴肢端麻木或抽搐；我们的资料表明BS 较GS 有更严重的 低血钾（P ＜0.05 ）；而GS 血镁低、尿钙尿肌酐比值明显下降；两组肾素活性、血醛固酮水平无明显差异； 两组经补钾或联合吲哚美辛、螺内酯等药物治疗后血钾均可上升；随访患者均仅长期补钾治疗，症状消失， 血钾均未恢复正常。结论 与BS 相比，GS 更常表现肢端麻木或抽搐，低血钾程度轻，而尿钙尿肌酐比值 明显下降；单纯长期补钾治疗可消除症状，但不能达到治疗目标。 【关键词】 Gitelman 综合征； Bartter 综合征； 临床分析 Clinical analysis of Bartter syndrome and Gitelman syndrome YANG Chi-jiao, CAO Xiao -pei, FU Juan, XIAO Hai -peng, LIAO Zhi-hong, LI Yan-bing. Department of Endocrinology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China Corresponding author: CAO Xiao-pei, Email: caoxp@mail.sysu.edu.cn 【Abstract 】 Objective To analyze and compare the clinical and laboratory characteristics of Bartter syndrome (BS) and Gitelman syndrome (GS) for further improvement of diagnosis and treatment. Method Clinic data of 15 BS and 11 GS were collected. Results Fourteen in 15 patients with BS experienced different degrees of fatigue or lower limb weakness. While GS had varying degrees of weakness, but generally accompanied by numbness or twitching of limbs. Patients with BS may complicated with more severe hypokalemia than GS(P ＜0.05). While the serum magnesium and the ratio of urinary calcium and urinary creatinine decreased significantly. The based plasma renin activity and based aldosterone were markedly elevated in both groups, while there was no statistical significance. The symptoms of BS or GS patients were relieved by supplementation with potassium alone or in combination with indomethacin, spiro