"Refers to the acute glomerular inflammation, blood group, type 2 Streptococcus." profile "nephritogenic strains" after infection, autoimmune reaction caused by nephritis. Cationic antigen streptococcal cell membrane and the cytoplasm of the first plant in glomerulus, and then form the immune complexes deposited with pathogenic circulating antibodies. The basic pathological changes of endocapillary proliferative glomerulonephritis.
Acute nephritis occurs in children, adolescents, more men than women. In the upper respiratory tract infection or skin infection in 1. 3 weeks after the onset of acute onset, hematuria, edema, hypertension, and oliguria, few acute renal failure occurred. About 40% of the patients had hematuria, proteinuria, few patients showed proteinuria, see white blood cells in urinary sediment, such as pipe type tube type particles are common, red blood cell tube type. Blood pressure was mild, moderately elevated. Minority patients blood urea nitrogen, creatinine increased. Immunological tests showed that serum complement C3 and complement decreased (onset within 8 weeks of recovery). Anti - "O ', normal or increased, part of circulating immune complexes in patients with serum cryoglobulin positive. Atypical cases treated from 1 to February was no better to renal biopsy to confirm the diagnosis. The treatment of this disease with rest and symptomatic treatment, because the disease is self limiting Disease should not use glucocorticoid and cytotoxic drugs. Patients should be dialysis of acute renal failure.
(a) antibiotics including penicillin, cephalosporins, quinolones and other antimicrobial agents. Cha
(two) antihypertensive drugs including angiotensin converting enzyme inhibitors (ACEI), angiotensin H receptor antagonist (ARB), calcium channel two hydrogen pyridine class blocking drugs.
Furosemide (Lasix): 1. bark mix diuretic, strong diuretic effect, can inhibit the resorption of the ascending branch of the medulla and spinal cord with the cortex of Cl and Na +, influence the formation and maintenance of renal medulla hyperosmolar state, decrease urine concentrating function, promote Cl, Na +, K + and water discharge to start, the diuretic effect. Daily oral 20 40mg, according to the condition also can adjust the dosage, intramuscular or intravenous drugs. A large number of applications can cause hypokalemia, electrolyte disorder, can reduce uric acid excretion and mildly elevated blood sugar, with caution, patients with gout and diabetes liver, renal dysfunction with caution, hepatic coma, pregnant women. Excessive use of digitalis were banned.2. hydrogen chloride during paint (HydroDIURIL): bite CA class effect diuretic, can inhibit the resorption of medullary cortex of ramus mix Cl and Na +, promote the excretion and diuretic effect. In addition, there is inhibition of carbonic anhydrase mild effect. Start a daily 25 75mg orally, according to the condition of the patient dose, daily maintenance dose of 25? 50mg. The adverse reactions of low blood potassium, gastrointestinal symptoms and rash. Liver and kidney dysfunction, gout and diabetes patients with caution.
3. spironolactone is inefficient: diuretics, and aldosterone in the distal tubule and collecting duct cortical segment competition, promote the excretion of Na + and Cl and diuretic effect, because Na eleven K ten exchange mechanism of inhibition, the potassium in urine decreased, as potassium sparing diuretics. Start a daily oral 40 80mg, then according to the condition of gradually reducing, daily maintenance dose of 20 40mg. There are hyperkalemia, headache, drowsiness, ataxia and other adverse reactions. A large number of long-term application can cause gynecomastia, loss of libido, female menstruation. Renal failure and high blood potassium were banned.
4. triamterene suck (three chlorine butterfly steep): inhibition of distal tubule and collecting duct cortical segment on Na + reabsorption, increase C1 and Na + excretion produced a diuretic effect, a retention effect on K + 50. Daily oral 150mg, occasional nausea, somnolence, dry mouth, adverse reaction rash. Serious liver and kidney dysfunction, with hyperkalemia were banned. Selection of respiratory tract infection, should use antibiotics in the treatment of infection, use of penicillin, cephalosporins antibiotics; allergy can be used in vinegar macrocyclic antibiotics, such as erythromycin, roxithromycin, etc., can also be used to bite quinolones such as ciprofloxacin. Edema obviously use CA Suo diuretic such as hydrogen chloride, hole throat, 25mg orally, 3 times a day 2, ineffective application of bark Sammy. Each time a 20 60mg oral or intramuscular injection, intravenous injection; such as low blood potassium is edema, can be added with Paul potassium diuretic Agents such as spironolactone, triamterene. After sucking with diuretics relieve edema, blood pressure drops, you do not have to use other antihypertensive drugs. If the blood pressure is not satisfied, with angiotensin converting enzyme (ACEI) inhibitors or angiotensin 11 receptor antagonist (ARB), can also choose long-term calcium channel two hydrogen pyridine class blocking drugs, such as Nifedipine Controlled Release Tablets, Felodipine Sustained Release Tablets and amlodipine. But less urine, with potassium sparing diuretics and ACEI, prevent the occurrence of hyperkalemia.