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军事训练相关性急性肾损伤
作者:吴广礼 黄旭东 
单位:050082 石家庄 联勤保障部队第980医院(原白求恩国际和平医院)肾脏病科(吴广礼、黄旭东) 
关键词:军事训练 肾损伤 诊断 治疗 
分类号:R692.5
出版年,卷(期):页码:2019,44(7):555-560
摘要:

军事训练相关性急性肾损伤(MTRAKI)为战时和平时训练的常见病、多发病,重症者可导致死亡,严重影响部队战斗力。该文重点介绍了军事训练相关性肾损伤的临床特征(临床表现、临床分型、临床诊断)、易患因素(身体素质下降、环境因素、营养状况、能量摄入水平、基因易感性)及发病机制(军事训练引起体内血液重新分布导致肾缺血、氧化应激反应、炎症反应及细胞凋亡均可造成或者加重肾损伤)。对于重症军事训练相关性肾损伤患者,连续性肾脏替代治疗(CRRT)可以更好地稳定内环境,清除毒素及炎性介质,显著降低病死率。该文旨在提高对军事训练相关性肾损伤的认识,降低其发生率,并达到早期发现、及时治疗的目的。

Military training-related acute kidney injury (MTRAKI) is a common and frequently occurring disease during training in war and peacetime, and severe MTRAKI may cause death and seriously affect the combat effectiveness of the army. The present paper focuses on the clinical features of MTRAKI, including clinical manifestations, classification and diagnosis, and also summarizes the predisposing factors, including the increase in training intensity, the decline in physical fitness of training personnel, environmental factors, nutritional status, energy intake level and genetic susceptibility. And the pathogenesis of MTRAKI was also discussed. It is believed that the redistribution of blood caused by military training can cause kidney ischemia, oxidative stress, inflammation and apoptosis, thus to cause or aggravate MTRAKI. For critically ill patients, continuous renal replacement therapy (CRRT) can better stabilize the internal environment, remove toxins and inflammatory mediators, and greatly reduce mortality. The purpose of present paper is to improve the understanding of MTRAKI, reduce the incidence, and achieve early detection and timely treatment.

基金项目:
全军医学科研“十二五”课题(CBJ14J013,CWS12J061);2017年河北省政府资助医院优秀人才项目和基础课题研究项目(和平-2);全军医学科技青年培育计划(16QNP072)
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