临床儿科杂志 ›› 2016, Vol. 34 ›› Issue (12): 891-.doi: 10.3969/j.issn.1000-3606.2016.12.003

• 内分泌遗传代谢性疾病专栏 • 上一篇    下一篇

呋塞米/ 氢氯噻嗪负荷试验在儿童Bartter 综合征和Gitelman 综合征鉴别诊断中的应用

张军, 陈秋莉, 李燕虹, 杜敏联, 马华梅, 陈红珊, 郭松   

  1. 中山大学附属第一医院儿科(广东广州 510080)
  • 收稿日期:2016-12-15 出版日期:2016-12-15 发布日期:2016-12-15
  • 通讯作者: 杜敏联 E-mail:szzxsums@163 .com

Utilization of furosemide/hydrochlorothiazide load test in differential diagnosis of Bartter syndrome from Gitelman syndrome in children

ZHANG Jun, CHEN Qiuli, LI Yanhong, DU Minlian, MA Huamei, CHEN Hongshan, GUO Song   

  1. Department of Pediatrics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080 , Guangdong, China
  • Received:2016-12-15 Online:2016-12-15 Published:2016-12-15

摘要: 目的 探讨呋塞米/氢氯噻嗪负荷试验对Bartter综合征和Gitelman综合征临床分型和选择目标基因检查的
意义。 方法 回顾性分析2012年至2014年5例临床诊断为Bartter综合征和Gitelman综合征患儿的临床表现、生化指标、 呋塞米/氢氯噻嗪负荷试验和基因检测结果。 结果 5例患儿均表现为低钾血症、代谢性碱中毒,基础肾素、血管紧张素Ⅱ、 醛固酮升高,血压正常。大部分患儿有多饮、多尿,并伴有不同程度的生长迟缓。 5例患儿基因诊断均与临床上根据呋塞 米/氢氯噻嗪负荷试验作出的诊断吻合。 结论 呋塞米/氢氯噻嗪负荷试验,能较好地将Bartter综合征和Gitelman综合征 相鉴别,进行初步分型,并指导选择较有针对性的目标基因检测。

Abstract: Objective To explore the application of furosemide/hydrochlorothiazide load test in clinical classification of Bartter syndrome and Gitelman syndrome and the significance of selecting target genes. Method The clinical features, biomarkers, the furosemide/hydrochlorothiazide load test, and gene detection in 5 patients with Bartter syndrome and Gitelman syndrome were retrospectively analyzed during 2012 to 2014. Results All of those 5 patients were manifested low potassium and metabolic acidosis; basis of renin, angiotensin II, and aldosterone were elevated. The blood pressures were normal. Most of the patients suffered from polydipsia, diuresis, and different degrees of growth retardation. The gene analysis of these 5 patients made the same diagnoses as furosemide/hydrochlorothiazide load test did. Conclusions Furosemide/hydrochlorothiazide load test can make a differentiation of Bartter syndrome from Gitelman syndrome and thus it can guide the selection of targeted gene detection.