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4.一氧化氮（NO）吸入新生儿低氧性呼吸衰竭伴持续肺动脉高压，可以吸入NO治疗。
|
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起始剂量为10～20ppm3～6小时，随后改为5～10ppm，可以维持1～7天或更长时间，直到缺氧状况根本缓解（参见本篇第十三章第三节）。
|
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（八）利尿剂在呼吸衰竭伴急性肺水肿、急性心力衰竭时，可以应用呋塞米促进肺液吸收、减轻心脏负荷。
|
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"entity": "急性肺水肿",
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"entity": "急性心力衰竭",
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"entity": "呋塞米",
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"id": 5,
"entity": "肺液",
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"label": "bod"
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{
"id": 6,
"entity": "心脏",
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七、肾活检的并发症及处理肾活检属比较安全的手术，严格掌握操作步骤可降低并发症发生率，远较肝穿刺安全。
|
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"entity": "肝穿刺",
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（一）血尿术后镜下血尿的发生率占穿刺病例的80%～90%，为组织损伤后常见的临床表现，并不视为并发症。
|
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血尿通常在1～5天内消失，无需特殊处理。
|
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镜下血尿发生率为49.8%～86.7%，一般24～48小时后消失。
|
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肉眼血尿多在1天内消失，少数病例持续1周。
|
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术前有肉眼血尿，尤其IgA肾病患者以反复发作型肉眼血尿为临床表现者；持续性高血压；肾功能受损者；取出组织过长者出现肉眼血尿的机会较多。
|
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"entity": "持续性高血压",
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"entity": "肾功能受损者",
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"entity": "血尿",
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对于一过性肉眼血尿的患者，除严格卧床休息、多饮水增加尿量外，无特别治疗。
|
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{
"id": 1,
"entity": "尿量",
"start_offset": 26,
"end_offset": 28,
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若血尿持续不止，应进一步检查凝血功能，排除隐匿性凝血功能异常，并动态观察血中血红蛋白，对失血量较大或出血时间较长的患者，应及时输新鲜血，同时静脉给予维生素K1</sub>促进凝血因子合成，增强止血效果。
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"entity": "隐匿性凝血功能异常",
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"entity": "新鲜血",
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"id": 9,
"entity": "血",
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为防止血块形成阻塞肾小管，予以适量碳酸氢钠碱化尿液。
|
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"entity": "碳酸氢钠",
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"entity": "尿液",
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经上述治疗血尿无明显缓解者，可以用小剂量垂体后叶素由输液泵静脉持续泵入。
|
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"entity": "静脉持续泵入",
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首次剂量为6～8U/h，尿色转淡后即减至4U/h，直到血尿完全消失24小时后。
|
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若经过以上措施出血仍不缓解，条件允许者还可行选择性肾动脉造影检查，明确出血灶后，采用插管的方法在局部注射硬化剂或自身血块栓塞血管，以达到止血的目的。
|
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{
"id": 5,
"entity": "血管",
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"end_offset": 64,
"label": "bod"
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（二）肾周围血肿文献报道肾周围血肿的发生率为0.5%～1.5%。
|
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"entity": "肾周围血肿",
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一般患者仅诉腹痛、腰痛，体格检查时可发现穿刺部位有压痛或较对侧膨隆，若血红蛋白、血细胞比容下降血细胞则应作超声波或CT检查，以明确诊断并观察血肿大小，评估出血量。
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"entity": "较对侧膨隆",
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{
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"entity": "血红蛋白",
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{
"id": 6,
"entity": "血细胞比容",
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{
"id": 7,
"entity": "血细胞",
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{
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"entity": "超声波或CT检查",
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{
"id": 9,
"entity": "血肿",
"start_offset": 70,
"end_offset": 72,
"label": "sym"
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发生肾周围血肿时，患者应绝对卧床休息，适当应用抗生素，预防血肿感染。
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一般病例保守治疗后出血可自行停止，少数血红蛋白下降较多者需输血。
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严重者输血持续增大，则须手术止血。
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肾周围血肿分为有临床意义和无临床意义两种，前者是指实验室检查血细胞比容较穿刺前降低4%以上。
|
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"entity": "穿刺",
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血肿多在1个月内自行吸收消失，出血量大导致血压、脉搏发生变化时需输血。
|
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经内科治疗仍出血不止者需行手术止血，甚至切除肾脏。
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（三）动-静脉瘘文献报道肾穿刺引起动-静脉瘘发生率仅为15%～18%，其中多数患者无临床症状。
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临床上存在高血压、肾间质纤维化、肾硬化及严重动脉病变的患者肾穿刺后较易出现此种并发症。
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一般无临床症状，若体检时闻及肾区血管性杂音，静脉肾盂造影偶见肾盏扭曲，则可疑为动-静脉瘘。
|
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"entity": "动-静脉瘘",
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肾动脉造影或彩色多普勒超声检查可以明确诊断。
|
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95%的动-静脉瘘患者在肾穿刺术后2～20个月内瘘管能自行闭合，很少要外科手术治疗，若出现大出血、高血压和心力衰竭时，应立即手术治疗，有人提出采用介入治疗，动脉插管注射氨基乙酸可以避免手术。
|
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{
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{
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{
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"entity": "心力衰竭",
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{
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"entity": "手术治疗",
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{
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"entity": "介入治疗",
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{
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"entity": "动脉插管注射氨基乙酸",
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}
] |
其他并发症有腰痛、腹胀、腹痛和放射痛、尿潴留等，但短期随访症状均会消失。
|
[
{
"id": 0,
"entity": "腰痛",
"start_offset": 6,
"end_offset": 8,
"label": "sym"
},
{
"id": 1,
"entity": "腹胀",
"start_offset": 9,
"end_offset": 11,
"label": "sym"
},
{
"id": 2,
"entity": "腹痛",
"start_offset": 12,
"end_offset": 14,
"label": "sym"
},
{
"id": 3,
"entity": "放射痛",
"start_offset": 15,
"end_offset": 18,
"label": "sym"
},
{
"id": 4,
"entity": "尿潴留",
"start_offset": 19,
"end_offset": 22,
"label": "sym"
}
] |
第二节生理特点肾脏的生理功能主要为排泄体内代谢产物如尿素和有机酸等；调节水和电解质平衡，维持内环境稳定以及内分泌功能如分泌肾素、前列腺素以及促红细胞生成素等。
|
[
{
"id": 0,
"entity": "肾脏",
"start_offset": 7,
"end_offset": 9,
"label": "bod"
},
{
"id": 1,
"entity": "代谢产物",
"start_offset": 21,
"end_offset": 25,
"label": "bod"
},
{
"id": 2,
"entity": "尿素",
"start_offset": 26,
"end_offset": 28,
"label": "bod"
},
{
"id": 3,
"entity": "有机酸",
"start_offset": 29,
"end_offset": 32,
"label": "bod"
},
{
"id": 4,
"entity": "水",
"start_offset": 36,
"end_offset": 37,
"label": "bod"
},
{
"id": 5,
"entity": "电解质",
"start_offset": 38,
"end_offset": 41,
"label": "bod"
},
{
"id": 6,
"entity": "内分泌",
"start_offset": 53,
"end_offset": 56,
"label": "bod"
},
{
"id": 7,
"entity": "肾素",
"start_offset": 61,
"end_offset": 63,
"label": "bod"
},
{
"id": 8,
"entity": "前列腺素",
"start_offset": 64,
"end_offset": 68,
"label": "bod"
},
{
"id": 9,
"entity": "促红细胞生成素",
"start_offset": 70,
"end_offset": 77,
"label": "bod"
}
] |
胚胎9～12周时肾脏开始形成尿液，但整个宫内时期胎儿内环境的稳定是靠胎盘维持，肾脏尚未发挥功能，胎尿为羊水的主要成分。
|
[
{
"id": 0,
"entity": "胚胎",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "肾脏",
"start_offset": 8,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "尿液",
"start_offset": 14,
"end_offset": 16,
"label": "bod"
},
{
"id": 3,
"entity": "宫",
"start_offset": 20,
"end_offset": 21,
"label": "bod"
},
{
"id": 4,
"entity": "胎盘",
"start_offset": 34,
"end_offset": 36,
"label": "bod"
},
{
"id": 5,
"entity": "肾脏",
"start_offset": 39,
"end_offset": 41,
"label": "bod"
},
{
"id": 6,
"entity": "胎尿",
"start_offset": 48,
"end_offset": 50,
"label": "bod"
},
{
"id": 7,
"entity": "羊水",
"start_offset": 51,
"end_offset": 53,
"label": "bod"
}
] |
肾脏的发育约在胎龄36周时完成，此时肾单位数量已达成人量。
|
[
{
"id": 0,
"entity": "肾脏",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "肾单位",
"start_offset": 18,
"end_offset": 21,
"label": "bod"
}
] |
足月新生儿出生后肾单位数量不再增加，但早产儿在出生后肾组织可继续发育，直至相当于胎龄36周为止，因此早产儿出生时肾功能较差。
|
[
{
"id": 0,
"entity": "肾单位",
"start_offset": 8,
"end_offset": 11,
"label": "bod"
},
{
"id": 1,
"entity": "肾组织",
"start_offset": 26,
"end_offset": 29,
"label": "bod"
},
{
"id": 2,
"entity": "肾",
"start_offset": 56,
"end_offset": 57,
"label": "bod"
}
] |
肾功能除与肾脏本身发育成熟有关外，尚受神经-内分泌以及体液分布等影响。
|
[
{
"id": 0,
"entity": "肾",
"start_offset": 0,
"end_offset": 1,
"label": "bod"
},
{
"id": 1,
"entity": "肾脏",
"start_offset": 5,
"end_offset": 7,
"label": "bod"
},
{
"id": 2,
"entity": "神经-内分泌",
"start_offset": 19,
"end_offset": 25,
"label": "bod"
},
{
"id": 3,
"entity": "体液",
"start_offset": 27,
"end_offset": 29,
"label": "bod"
}
] |
足月儿出生时已能完成肾脏的生理功能，但贮备能力差，调节功能不够成熟，当喂养不当、疾病或应激状态时易出现功能紊乱。
|
[
{
"id": 0,
"entity": "肾脏",
"start_offset": 10,
"end_offset": 12,
"label": "bod"
},
{
"id": 1,
"entity": "当喂养不当、疾病或应激状态时易出现功能紊乱",
"start_offset": 34,
"end_offset": 55,
"label": "sym"
}
] |
到1～2岁时各项肾功能按体表面积计算已接近成人水平。
|
[
{
"id": 0,
"entity": "肾",
"start_offset": 8,
"end_offset": 9,
"label": "bod"
}
] |
（一）肾小球的滤过作用新生儿出生时肾小球数目虽与成人相等，但肾小球滤过率甚低，平均约每分钟20ml/1.73m2</sup>，早产儿则更低。
|
[
{
"id": 0,
"entity": "肾小球",
"start_offset": 3,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "肾小球",
"start_offset": 17,
"end_offset": 20,
"label": "bod"
},
{
"id": 2,
"entity": "肾小球滤过率",
"start_offset": 30,
"end_offset": 36,
"label": "ite"
}
] |
因此过量的水分和溶质不能迅速有效地排出，原因是：①新生儿肾滤过作用主要由近髓的成熟肾小球负担；皮质表面的肾小球发育差，血流供应量少，基本不参加滤过作用。
|
[
{
"id": 0,
"entity": "肾",
"start_offset": 28,
"end_offset": 29,
"label": "bod"
},
{
"id": 1,
"entity": "髓",
"start_offset": 37,
"end_offset": 38,
"label": "bod"
},
{
"id": 2,
"entity": "成熟肾小球",
"start_offset": 39,
"end_offset": 44,
"label": "bod"
},
{
"id": 3,
"entity": "皮质表面",
"start_offset": 47,
"end_offset": 51,
"label": "bod"
},
{
"id": 4,
"entity": "肾小球",
"start_offset": 52,
"end_offset": 55,
"label": "bod"
},
{
"id": 5,
"entity": "血",
"start_offset": 59,
"end_offset": 60,
"label": "bod"
}
] |
②入球小动脉阻力较高，影响肾小球的血流量。
|
[
{
"id": 0,
"entity": "入球小动脉",
"start_offset": 1,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "肾小球",
"start_offset": 13,
"end_offset": 16,
"label": "bod"
},
{
"id": 2,
"entity": "血流量",
"start_offset": 17,
"end_offset": 20,
"label": "ite"
}
] |
③新生儿血压低，故肾小球滤过压也较低。
|
[
{
"id": 0,
"entity": "血压",
"start_offset": 4,
"end_offset": 6,
"label": "ite"
},
{
"id": 1,
"entity": "肾小球滤过压",
"start_offset": 9,
"end_offset": 15,
"label": "ite"
}
] |
出生后一周开始，肾血管阻力下降，皮质浅表肾单位开放，肾血流量增加，肾小球滤过压升高，因此肾小球滤过率迅速增加，至1岁时已接近成人水平。
|
[
{
"id": 0,
"entity": "肾血管",
"start_offset": 8,
"end_offset": 11,
"label": "bod"
},
{
"id": 1,
"entity": "皮质",
"start_offset": 16,
"end_offset": 18,
"label": "bod"
},
{
"id": 2,
"entity": "肾单位",
"start_offset": 20,
"end_offset": 23,
"label": "bod"
},
{
"id": 3,
"entity": "肾",
"start_offset": 26,
"end_offset": 27,
"label": "bod"
},
{
"id": 4,
"entity": "肾小球滤过压",
"start_offset": 33,
"end_offset": 39,
"label": "ite"
},
{
"id": 5,
"entity": "肾小球滤过率",
"start_offset": 44,
"end_offset": 50,
"label": "ite"
}
] |
（二）肾小管的重吸收及排泄功能肾小管对肾小球滤液中的水及各种溶质选择性地重吸收，以保持机体内环境的稳定。
|
[
{
"id": 0,
"entity": "肾小管",
"start_offset": 3,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "肾小管",
"start_offset": 15,
"end_offset": 18,
"label": "bod"
},
{
"id": 2,
"entity": "肾小球滤液",
"start_offset": 19,
"end_offset": 24,
"label": "bod"
}
] |
肾小管的重吸收与肾小球滤过率保持密切的联系，这一现象称为球-管平衡。
|
[
{
"id": 0,
"entity": "肾小管",
"start_offset": 0,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "肾小球滤过率",
"start_offset": 8,
"end_offset": 14,
"label": "ite"
}
] |
许多实验资料证明，尽管在形态上肾小管的发育落后于肾小球，但肾小管功能在出生后已能保持球-管平衡。
|
[
{
"id": 0,
"entity": "肾小管",
"start_offset": 15,
"end_offset": 18,
"label": "bod"
},
{
"id": 1,
"entity": "肾小球",
"start_offset": 24,
"end_offset": 27,
"label": "bod"
},
{
"id": 2,
"entity": "肾小管",
"start_offset": 29,
"end_offset": 32,
"label": "bod"
}
] |
足月新生儿氨基酸及葡萄糖的重吸收能力正常，出生后已能维持钠平衡，但调节幅度有限，钠的重吸收主要在远端肾小管（成人主要在近端肾小管），此可能与新生儿血循环中醛固酮含量较高有关。
|
[
{
"id": 0,
"entity": "氨基酸",
"start_offset": 5,
"end_offset": 8,
"label": "bod"
},
{
"id": 1,
"entity": "葡萄糖",
"start_offset": 9,
"end_offset": 12,
"label": "bod"
},
{
"id": 2,
"entity": "钠",
"start_offset": 28,
"end_offset": 29,
"label": "bod"
},
{
"id": 3,
"entity": "钠",
"start_offset": 40,
"end_offset": 41,
"label": "bod"
},
{
"id": 4,
"entity": "近端肾小管",
"start_offset": 59,
"end_offset": 64,
"label": "bod"
},
{
"id": 5,
"entity": "血",
"start_offset": 73,
"end_offset": 74,
"label": "bod"
},
{
"id": 6,
"entity": "醛固酮",
"start_offset": 77,
"end_offset": 80,
"label": "bod"
}
] |
同时由于肾小球滤过率较低，因此在钠负荷量过大时不能迅速排钠，而易致水肿。
|
[
{
"id": 0,
"entity": "肾小球",
"start_offset": 4,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "钠",
"start_offset": 16,
"end_offset": 17,
"label": "bod"
},
{
"id": 2,
"entity": "钠",
"start_offset": 28,
"end_offset": 29,
"label": "bod"
},
{
"id": 3,
"entity": "水肿",
"start_offset": 33,
"end_offset": 35,
"label": "dis"
}
] |
早产儿肾功能尚不成熟，葡萄糖肾阈较低，易出现糖尿。
|
[
{
"id": 0,
"entity": "肾",
"start_offset": 3,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "葡萄糖",
"start_offset": 11,
"end_offset": 14,
"label": "bod"
},
{
"id": 2,
"entity": "肾",
"start_offset": 14,
"end_offset": 15,
"label": "bod"
},
{
"id": 3,
"entity": "糖尿",
"start_offset": 22,
"end_offset": 24,
"label": "dis"
}
] |
低出生体重儿排钠较多，如摄入量过低，可出现钠的负平衡而致低钠血症。
|
[
{
"id": 0,
"entity": "钠",
"start_offset": 7,
"end_offset": 8,
"label": "bod"
},
{
"id": 1,
"entity": "钠",
"start_offset": 21,
"end_offset": 22,
"label": "bod"
},
{
"id": 2,
"entity": "低钠血症",
"start_offset": 28,
"end_offset": 32,
"label": "dis"
}
] |
新生儿最初10～20天内对钾的排泄能力较差，故有高钾血症的倾向。
|
[
{
"id": 0,
"entity": "钾",
"start_offset": 13,
"end_offset": 14,
"label": "bod"
},
{
"id": 1,
"entity": "高钾血症",
"start_offset": 24,
"end_offset": 28,
"label": "dis"
}
] |
（三）尿的浓缩和稀释新生儿及幼婴对尿的稀释能力接近成人，新生儿已能将原尿稀释至40mmol/L［40mOsm/（kg•H2</sub>O）］。
|
[
{
"id": 0,
"entity": "尿",
"start_offset": 3,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "尿",
"start_offset": 17,
"end_offset": 18,
"label": "bod"
},
{
"id": 2,
"entity": "原尿",
"start_offset": 34,
"end_offset": 36,
"label": "bod"
}
] |
但由于肾小球滤过率低，利尿速度慢，大量水负荷时易出现水肿。
|
[
{
"id": 0,
"entity": "肾小球滤过率",
"start_offset": 3,
"end_offset": 9,
"label": "ite"
},
{
"id": 1,
"entity": "尿",
"start_offset": 12,
"end_offset": 13,
"label": "bod"
},
{
"id": 2,
"entity": "水肿",
"start_offset": 26,
"end_offset": 28,
"label": "dis"
}
] |
初生婴儿对尿的浓缩能力不及年长儿及成人，这主要由于婴儿蛋白合成代谢旺盛，而肾小球滤过率低，尿素排出较少，滤液中尿素量不足以在髓质中形成较高的渗透压梯度，因而影响尿的浓缩。
|
[
{
"id": 0,
"entity": "尿",
"start_offset": 5,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "蛋白",
"start_offset": 27,
"end_offset": 29,
"label": "bod"
},
{
"id": 2,
"entity": "肾小球",
"start_offset": 37,
"end_offset": 40,
"label": "bod"
},
{
"id": 3,
"entity": "尿素",
"start_offset": 45,
"end_offset": 47,
"label": "bod"
},
{
"id": 4,
"entity": "滤液",
"start_offset": 52,
"end_offset": 54,
"label": "bod"
},
{
"id": 5,
"entity": "尿素",
"start_offset": 55,
"end_offset": 57,
"label": "bod"
},
{
"id": 6,
"entity": "髓质",
"start_offset": 62,
"end_offset": 64,
"label": "bod"
},
{
"id": 7,
"entity": "渗透压",
"start_offset": 70,
"end_offset": 73,
"label": "ite"
},
{
"id": 8,
"entity": "尿",
"start_offset": 80,
"end_offset": 81,
"label": "bod"
}
] |
婴儿每由尿内排出1mmol的溶质需水1.4～2.4ml，而成人仅需0.7ml。
|
[
{
"id": 0,
"entity": "尿",
"start_offset": 4,
"end_offset": 5,
"label": "bod"
}
] |
婴儿尿最高渗透压仅达700mmol/L［700mOsm/（kg•H2</sub>O）］，而成人可达1400mmol/L［1400mOsm/（kg•H2</sub>O）］，在正常情况下，婴儿这种浓缩能力的缺陷并无重要影响，但在负荷过重的情况下则易发生脱水，甚至诱发急性肾功能不全。
|
[
{
"id": 0,
"entity": "尿最高渗透压",
"start_offset": 2,
"end_offset": 8,
"label": "ite"
},
{
"id": 1,
"entity": "脱水",
"start_offset": 124,
"end_offset": 126,
"label": "sym"
},
{
"id": 2,
"entity": "急性肾功能不全",
"start_offset": 131,
"end_offset": 138,
"label": "dis"
}
] |
（四）酸碱平衡肾脏通过H+</sup>的排泌及的重吸收以维持酸碱平衡。
|
[
{
"id": 0,
"entity": "肾脏",
"start_offset": 7,
"end_offset": 9,
"label": "bod"
},
{
"id": 1,
"entity": "H+",
"start_offset": 11,
"end_offset": 13,
"label": "ite"
}
] |
新生儿由于肾小管液中磷酸盐及NH3</sub>的浓度较低，实际能排出的H+</sup>较少，约1～2个月时尿中的可滴定酸可达成人水平，排氨能力至2岁方接近成人。
|
[
{
"id": 0,
"entity": "肾小管液",
"start_offset": 5,
"end_offset": 9,
"label": "bod"
},
{
"id": 1,
"entity": "磷酸盐",
"start_offset": 10,
"end_offset": 13,
"label": "bod"
},
{
"id": 2,
"entity": "H+",
"start_offset": 35,
"end_offset": 37,
"label": "ite"
},
{
"id": 3,
"entity": "尿",
"start_offset": 53,
"end_offset": 54,
"label": "ite"
}
] |
新生儿碳酸氢盐的肾阈较低（约比成人低4～6mmol/L），超过肾阈时即由尿排出。
|
[
{
"id": 0,
"entity": "碳酸氢盐",
"start_offset": 3,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "肾",
"start_offset": 8,
"end_offset": 9,
"label": "bod"
},
{
"id": 2,
"entity": "肾",
"start_offset": 31,
"end_offset": 32,
"label": "bod"
},
{
"id": 3,
"entity": "尿",
"start_offset": 36,
"end_offset": 37,
"label": "bod"
}
] |
婴儿在正常情况下酸碱平衡的调节能力已达最高限度，不足以应付病理状况下的额外负担，较易出现酸中毒。
|
[
{
"id": 0,
"entity": "酸中毒",
"start_offset": 44,
"end_offset": 47,
"label": "dis"
}
] |
（五）肾脏的内分泌功能肾脏不仅是一个排泄器官，而且是一个重要的内分泌器官。
|
[
{
"id": 0,
"entity": "肾脏",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "肾脏",
"start_offset": 11,
"end_offset": 13,
"label": "bod"
}
] |
它可以通过自分泌、旁分泌及胞分泌的形式产生一系列内分泌性生物活性物质，在调节身体血压、水电解质平衡、钙、磷等许多方面起重要作用。
|
[
{
"id": 0,
"entity": "内分泌性生物活性物质",
"start_offset": 24,
"end_offset": 34,
"label": "bod"
},
{
"id": 1,
"entity": "血压",
"start_offset": 40,
"end_offset": 42,
"label": "ite"
},
{
"id": 2,
"entity": "水电解质",
"start_offset": 43,
"end_offset": 47,
"label": "bod"
},
{
"id": 3,
"entity": "钙",
"start_offset": 50,
"end_offset": 51,
"label": "bod"
},
{
"id": 4,
"entity": "磷",
"start_offset": 52,
"end_offset": 53,
"label": "bod"
}
] |
肾脏能分泌多种生物活性物质，如前列腺素、肾素、激肽释放酶、促红细胞生成素、1，25-二羟骨化醇以及内皮素与一氧化氮（NO）等。
|
[
{
"id": 0,
"entity": "肾脏",
"start_offset": 0,
"end_offset": 2,
"label": "bod"
},
{
"id": 1,
"entity": "前列腺素",
"start_offset": 15,
"end_offset": 19,
"label": "bod"
},
{
"id": 2,
"entity": "肾素",
"start_offset": 20,
"end_offset": 22,
"label": "bod"
},
{
"id": 3,
"entity": "激肽释放酶",
"start_offset": 23,
"end_offset": 28,
"label": "bod"
},
{
"id": 4,
"entity": "促红细胞生成素",
"start_offset": 29,
"end_offset": 36,
"label": "bod"
},
{
"id": 5,
"entity": "25-二羟骨化醇",
"start_offset": 39,
"end_offset": 47,
"label": "bod"
},
{
"id": 6,
"entity": "内皮素",
"start_offset": 49,
"end_offset": 52,
"label": "bod"
},
{
"id": 7,
"entity": "一氧化氮",
"start_offset": 53,
"end_offset": 57,
"label": "bod"
},
{
"id": 8,
"entity": "NO",
"start_offset": 58,
"end_offset": 60,
"label": "bod"
}
] |
新生儿肾脏已具内分泌功能，释出肾素较多，新生儿血浆肾素、血管紧张素以及醛固酮均高于成人，生后2周内渐降低。
|
[
{
"id": 0,
"entity": "肾脏",
"start_offset": 3,
"end_offset": 5,
"label": "bod"
},
{
"id": 1,
"entity": "肾素",
"start_offset": 15,
"end_offset": 17,
"label": "bod"
},
{
"id": 2,
"entity": "血浆肾素",
"start_offset": 23,
"end_offset": 27,
"label": "bod"
},
{
"id": 3,
"entity": "血管紧张素",
"start_offset": 28,
"end_offset": 33,
"label": "bod"
},
{
"id": 4,
"entity": "醛固酮",
"start_offset": 35,
"end_offset": 38,
"label": "bod"
}
] |
胚胎肾已能合成前列腺素，脐带血中前列腺素E2</sub>含量甚高。
|
[
{
"id": 0,
"entity": "肾",
"start_offset": 2,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "前列腺素",
"start_offset": 7,
"end_offset": 11,
"label": "bod"
},
{
"id": 2,
"entity": "脐带血",
"start_offset": 12,
"end_offset": 15,
"label": "bod"
},
{
"id": 3,
"entity": "前列腺素E2",
"start_offset": 16,
"end_offset": 22,
"label": "bod"
}
] |
前列腺素E2</sub>有扩张血管作用，参与肾血流量的调节。
|
[
{
"id": 0,
"entity": "前列腺素E2",
"start_offset": 0,
"end_offset": 6,
"label": "bod"
},
{
"id": 1,
"entity": "血管",
"start_offset": 15,
"end_offset": 17,
"label": "bod"
},
{
"id": 2,
"entity": "肾",
"start_offset": 22,
"end_offset": 23,
"label": "bod"
}
] |
胎儿血氧分压较低，胚胎肾合成促红细胞生成素较多，生后随着血氧分压增高，促红细胞生成素合成减少。
|
[
{
"id": 0,
"entity": "血氧分压",
"start_offset": 2,
"end_offset": 6,
"label": "ite"
},
{
"id": 1,
"entity": "胚胎肾",
"start_offset": 9,
"end_offset": 12,
"label": "bod"
},
{
"id": 2,
"entity": "促红细胞生成素",
"start_offset": 14,
"end_offset": 21,
"label": "bod"
},
{
"id": 3,
"entity": "血氧分压",
"start_offset": 28,
"end_offset": 32,
"label": "ite"
},
{
"id": 4,
"entity": "促红细胞生成素",
"start_offset": 35,
"end_offset": 42,
"label": "bod"
}
] |
二、血小板无力症瑞士医师Glanzmann于1918年首先报道本病，故又称Glanzmannthrombasthenia（GT）。
|
[
{
"id": 0,
"entity": "血小板无力症",
"start_offset": 2,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "Glanzmannthrombasthenia",
"start_offset": 37,
"end_offset": 60,
"label": "dis"
},
{
"id": 2,
"entity": "GT",
"start_offset": 61,
"end_offset": 63,
"label": "dis"
}
] |
其特点是血小板的形态、数量正常，出血时间延长，血块收缩不良或不收缩，聚集功能缺陷。
|
[
{
"id": 0,
"entity": "血小板",
"start_offset": 4,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "血小板的形态、数量正常，出血时间延长，血块收缩不良或不收缩，聚集功能缺陷",
"start_offset": 4,
"end_offset": 40,
"label": "sym"
}
] |
【发病机制】GT的生化缺陷在于血小板膜糖蛋白GPⅡb/Ⅲa复合物量的减少、缺失或质的异常。
|
[
{
"id": 0,
"entity": "GT",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "血小板膜糖蛋白GPⅡb/Ⅲa复合物",
"start_offset": 15,
"end_offset": 32,
"label": "bod"
}
] |
GPⅡb/Ⅲa在其周围微环境发生改变或因血小板激活使其构型改变时，可作为受体与纤维蛋白原、vWF、纤维连接蛋白、层素等黏附分子结合，介导血小板聚集。
|
[
{
"id": 0,
"entity": "GPⅡb/Ⅲa",
"start_offset": 0,
"end_offset": 7,
"label": "bod"
},
{
"id": 1,
"entity": "血小板",
"start_offset": 20,
"end_offset": 23,
"label": "bod"
},
{
"id": 2,
"entity": "纤维蛋白原",
"start_offset": 39,
"end_offset": 44,
"label": "bod"
},
{
"id": 3,
"entity": "vWF",
"start_offset": 45,
"end_offset": 48,
"label": "bod"
},
{
"id": 4,
"entity": "纤维连接蛋白",
"start_offset": 49,
"end_offset": 55,
"label": "bod"
},
{
"id": 5,
"entity": "血小板",
"start_offset": 68,
"end_offset": 71,
"label": "bod"
}
] |
目前研究发现GPⅡb和GPⅢa由不同基因编码，都位于17号染色体上（17q21～23）GT是由于该基因发生了缺失、点突变或插入所致。
|
[
{
"id": 0,
"entity": "17号染色体",
"start_offset": 26,
"end_offset": 32,
"label": "bod"
}
] |
【实验室检查】血小板数量及形态正常，但在血片上散在不聚集，出血时间延长，血块收缩不良或不收缩。
|
[
{
"id": 0,
"entity": "血小板",
"start_offset": 7,
"end_offset": 10,
"label": "bod"
},
{
"id": 1,
"entity": "血块",
"start_offset": 36,
"end_offset": 38,
"label": "bod"
}
] |
如能测定可进一步发现血小板GPⅡb/Ⅲa复合物量的减少或质的异常。
|
[
{
"id": 0,
"entity": "血小板GPⅡb/Ⅲa复合物",
"start_offset": 10,
"end_offset": 23,
"label": "bod"
}
] |
（二）实验室检查1.血小板计数正常，血涂片上血小板散在分布，不聚集成堆。
|
[
{
"id": 0,
"entity": "血小板",
"start_offset": 10,
"end_offset": 13,
"label": "bod"
},
{
"id": 1,
"entity": "血小板",
"start_offset": 22,
"end_offset": 25,
"label": "bod"
}
] |
加瑞斯托霉素聚集正常或降低。
|
[
{
"id": 0,
"entity": "加瑞斯托霉素",
"start_offset": 0,
"end_offset": 6,
"label": "bod"
}
] |
5.血小板玻珠滞留试验减低。
|
[
{
"id": 0,
"entity": "血小板玻珠滞留试验",
"start_offset": 2,
"end_offset": 11,
"label": "pro"
}
] |
6.血小板膜糖蛋白（GP）Ⅱb/Ⅲa（CD41/CD61）减少或有质的异常。
|
[
{
"id": 0,
"entity": "血小板膜糖蛋白（GP）Ⅱb/Ⅲa（CD41/CD61）",
"start_offset": 2,
"end_offset": 29,
"label": "bod"
}
] |
五、婴儿血管外皮细胞瘤1942年Stont和Murray首先描述血管外皮细胞瘤，在小儿有特点，常称“类血管外皮细胞瘤”，多见于1岁左右的婴儿，仅50%左右发展为恶性。
|
[
{
"id": 0,
"entity": "婴儿血管外皮细胞瘤",
"start_offset": 2,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "血管外皮细胞瘤",
"start_offset": 32,
"end_offset": 39,
"label": "dis"
},
{
"id": 2,
"entity": "类血管外皮细胞瘤",
"start_offset": 50,
"end_offset": 58,
"label": "dis"
}
] |
肿瘤为多房性，大小不一，界限清楚，显微镜下肿瘤内毛细血管紧密聚集，肿瘤由血管扁平细胞组成，血管间有大量外皮细胞增生·。
|
[
{
"id": 0,
"entity": "肿瘤",
"start_offset": 0,
"end_offset": 2,
"label": "dis"
},
{
"id": 1,
"entity": "显微镜",
"start_offset": 17,
"end_offset": 20,
"label": "equ"
},
{
"id": 2,
"entity": "肿瘤",
"start_offset": 21,
"end_offset": 23,
"label": "dis"
},
{
"id": 3,
"entity": "毛细血管",
"start_offset": 24,
"end_offset": 28,
"label": "bod"
},
{
"id": 4,
"entity": "毛细血管紧密聚集",
"start_offset": 24,
"end_offset": 32,
"label": "sym"
},
{
"id": 5,
"entity": "肿瘤",
"start_offset": 33,
"end_offset": 35,
"label": "dis"
},
{
"id": 6,
"entity": "血管扁平细胞",
"start_offset": 36,
"end_offset": 42,
"label": "bod"
},
{
"id": 7,
"entity": "肿瘤由血管扁平细胞组成",
"start_offset": 33,
"end_offset": 44,
"label": "sym"
},
{
"id": 8,
"entity": "血管",
"start_offset": 45,
"end_offset": 47,
"label": "bod"
},
{
"id": 9,
"entity": "外皮细胞",
"start_offset": 51,
"end_offset": 55,
"label": "bod"
},
{
"id": 10,
"entity": "血管间有大量外皮细胞增生",
"start_offset": 45,
"end_offset": 57,
"label": "sym"
}
] |
肿瘤细胞向血管内生长，可见核分裂和坏死情况，在小儿中这并不提示恶性。
|
[
{
"id": 0,
"entity": "肿瘤细胞",
"start_offset": 0,
"end_offset": 4,
"label": "bod"
},
{
"id": 1,
"entity": "血管",
"start_offset": 5,
"end_offset": 7,
"label": "bod"
}
] |
少数情况下，肿瘤可向周围组织浸润，甚至远处转移，则肯定为恶性。
|
[
{
"id": 0,
"entity": "肿瘤",
"start_offset": 6,
"end_offset": 8,
"label": "dis"
},
{
"id": 1,
"entity": "组织",
"start_offset": 12,
"end_offset": 14,
"label": "bod"
}
] |
婴儿血管外皮细胞瘤（infantilehemangioendothelioma）多为良性，局部切除即可治愈，无需放疗、化疗。
|
[
{
"id": 0,
"entity": "婴儿血管外皮细胞瘤",
"start_offset": 0,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "infantilehemangioendothelioma",
"start_offset": 10,
"end_offset": 39,
"label": "dis"
},
{
"id": 2,
"entity": "局部切除",
"start_offset": 45,
"end_offset": 49,
"label": "pro"
},
{
"id": 3,
"entity": "放疗",
"start_offset": 56,
"end_offset": 58,
"label": "pro"
},
{
"id": 4,
"entity": "化疗",
"start_offset": 59,
"end_offset": 61,
"label": "pro"
}
] |
四、肾活检适应证凡肾脏有弥漫性病变，其病因、治疗和预后等问题尚未解决或不甚明确，又无禁忌证者，均为肾活检的适应证。
|
[
{
"id": 0,
"entity": "肾活检",
"start_offset": 2,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "肾脏",
"start_offset": 9,
"end_offset": 11,
"label": "bod"
},
{
"id": 2,
"entity": "弥漫性病变",
"start_offset": 12,
"end_offset": 17,
"label": "dis"
},
{
"id": 3,
"entity": "肾活检",
"start_offset": 49,
"end_offset": 52,
"label": "pro"
}
] |
它能对各种原发及继发性肾脏疾病的诊断提供直接依据，还可以了解病变的程度以及病情是否可逆等，从而直接指导临床治疗。
|
[
{
"id": 0,
"entity": "原发及继发性肾脏疾病",
"start_offset": 5,
"end_offset": 15,
"label": "dis"
}
] |
1.肾病综合征儿童肾病综合征（NS）可由多种原因引起，原发性NS又有多种病理类型，治疗及预后各有不同。
|
[
{
"id": 0,
"entity": "肾病综合征",
"start_offset": 2,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "儿童肾病综合征",
"start_offset": 7,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "NS",
"start_offset": 15,
"end_offset": 17,
"label": "dis"
},
{
"id": 3,
"entity": "原发性NS",
"start_offset": 27,
"end_offset": 32,
"label": "dis"
}
] |
对继发性NS以及对糖皮质激素治疗耐药和临床表现提示非单纯性NS的情况应行肾活检，以明确病理类型，指导治疗，判断预后。
|
[
{
"id": 0,
"entity": "继发性NS",
"start_offset": 1,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "非单纯性NS",
"start_offset": 25,
"end_offset": 31,
"label": "dis"
}
] |
由于儿童微小病变较多，对糖皮质激素治疗敏感，对这类患儿是否及早肾活检尚有不同意见。
|
[
{
"id": 0,
"entity": "糖皮质激素",
"start_offset": 12,
"end_offset": 17,
"label": "dru"
},
{
"id": 1,
"entity": "肾活检",
"start_offset": 31,
"end_offset": 34,
"label": "pro"
}
] |
2.急性肾炎综合征多种肾小球疾病均可表现为急性肾炎综合征，仅根据临床表现及实验检查相似，难以鉴别诊断，但病情发展、治疗和预后则完全不同。
|
[
{
"id": 0,
"entity": "急性肾炎综合征",
"start_offset": 2,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "肾小球疾病",
"start_offset": 11,
"end_offset": 16,
"label": "dis"
},
{
"id": 2,
"entity": "急性肾炎综合征",
"start_offset": 21,
"end_offset": 28,
"label": "dis"
}
] |
如IgA肾病、膜性肾病、新月体肾炎、急进性肾炎甚至系统性血管炎，因此对这类临床综合征应尽早行肾活检。
|
[
{
"id": 0,
"entity": "IgA肾病",
"start_offset": 1,
"end_offset": 6,
"label": "dis"
},
{
"id": 1,
"entity": "膜性肾病",
"start_offset": 7,
"end_offset": 11,
"label": "dis"
},
{
"id": 2,
"entity": "新月体肾炎",
"start_offset": 12,
"end_offset": 17,
"label": "dis"
},
{
"id": 3,
"entity": "急进性肾炎",
"start_offset": 18,
"end_offset": 23,
"label": "dis"
},
{
"id": 4,
"entity": "肾活检",
"start_offset": 46,
"end_offset": 49,
"label": "pro"
}
] |
3.无症状性蛋白尿肾功能正常，蛋白尿持续6个月以上，伴有血尿和（或）24小时尿蛋白达1g/m2</sup>，是肾活检的指征。
|
[
{
"id": 0,
"entity": "蛋白尿",
"start_offset": 6,
"end_offset": 9,
"label": "sym"
},
{
"id": 1,
"entity": "肾",
"start_offset": 9,
"end_offset": 10,
"label": "bod"
},
{
"id": 2,
"entity": "蛋白尿",
"start_offset": 15,
"end_offset": 18,
"label": "sym"
},
{
"id": 3,
"entity": "血尿",
"start_offset": 28,
"end_offset": 30,
"label": "sym"
},
{
"id": 4,
"entity": "尿蛋白",
"start_offset": 38,
"end_offset": 41,
"label": "ite"
},
{
"id": 5,
"entity": "肾活检",
"start_offset": 55,
"end_offset": 58,
"label": "pro"
}
] |
已有肾功能轻度不全的患者，就诊时若不能肯定诊断，特别是伴有镜下血尿和（或）高血压者都是肾活检的指征。
|
[
{
"id": 0,
"entity": "肾",
"start_offset": 2,
"end_offset": 3,
"label": "bod"
},
{
"id": 1,
"entity": "镜",
"start_offset": 29,
"end_offset": 30,
"label": "equ"
},
{
"id": 2,
"entity": "血尿",
"start_offset": 31,
"end_offset": 33,
"label": "sym"
},
{
"id": 3,
"entity": "高血压",
"start_offset": 37,
"end_offset": 40,
"label": "sym"
},
{
"id": 4,
"entity": "肾活检",
"start_offset": 43,
"end_offset": 46,
"label": "pro"
}
] |
4.原因不明的血尿反复发作性肉眼血尿或持续性镜下血尿持续6个月以上，已排除肾外因素，并经尿路造影及膀胱镜检查未能确诊者，可考虑肾活检；血尿伴有蛋白尿及管型者，更应考虑肾活检。
|
[
{
"id": 0,
"entity": "血尿",
"start_offset": 7,
"end_offset": 9,
"label": "sym"
},
{
"id": 1,
"entity": "血尿",
"start_offset": 16,
"end_offset": 18,
"label": "sym"
},
{
"id": 2,
"entity": "镜",
"start_offset": 22,
"end_offset": 23,
"label": "equ"
},
{
"id": 3,
"entity": "血尿",
"start_offset": 24,
"end_offset": 26,
"label": "sym"
},
{
"id": 4,
"entity": "肾",
"start_offset": 37,
"end_offset": 38,
"label": "bod"
},
{
"id": 5,
"entity": "尿路造影",
"start_offset": 44,
"end_offset": 48,
"label": "pro"
},
{
"id": 6,
"entity": "膀胱镜检查",
"start_offset": 49,
"end_offset": 54,
"label": "pro"
},
{
"id": 7,
"entity": "肾活检",
"start_offset": 63,
"end_offset": 66,
"label": "pro"
},
{
"id": 8,
"entity": "血尿",
"start_offset": 67,
"end_offset": 69,
"label": "sym"
},
{
"id": 9,
"entity": "蛋白尿",
"start_offset": 71,
"end_offset": 74,
"label": "sym"
},
{
"id": 10,
"entity": "管型",
"start_offset": 75,
"end_offset": 77,
"label": "sym"
},
{
"id": 11,
"entity": "肾活检",
"start_offset": 83,
"end_offset": 86,
"label": "pro"
}
] |
5.急性肾衰竭以前认为尿毒症时肾穿刺危险性大，但是近年来大多数作者倾向于对病因不明的急性肾衰竭患儿均应进行肾活检，这对确定原发病、选择治疗方案及判断预后有重要意义。
|
[
{
"id": 0,
"entity": "急性肾衰竭",
"start_offset": 2,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "尿毒症",
"start_offset": 11,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "肾穿刺",
"start_offset": 15,
"end_offset": 18,
"label": "pro"
},
{
"id": 3,
"entity": "急性肾衰竭",
"start_offset": 42,
"end_offset": 47,
"label": "dis"
},
{
"id": 4,
"entity": "肾活检",
"start_offset": 53,
"end_offset": 56,
"label": "pro"
}
] |
特别近年来药物引起的急性间质性肾炎日益增多，但临床有时很难与其他各种疾病引起的急性肾衰竭或肾小管间质性疾病相区别，肾活检可以做出正确诊断并选择正确的治疗措施。
|
[
{
"id": 0,
"entity": "急性间质性肾炎",
"start_offset": 10,
"end_offset": 17,
"label": "dis"
},
{
"id": 1,
"entity": "急性肾衰竭",
"start_offset": 39,
"end_offset": 44,
"label": "dis"
},
{
"id": 2,
"entity": "肾小管间质性疾病",
"start_offset": 45,
"end_offset": 53,
"label": "dis"
},
{
"id": 3,
"entity": "肾活检",
"start_offset": 57,
"end_offset": 60,
"label": "pro"
}
] |
6.结缔组织病肾脏为系统性红斑狼疮等多种结缔组织病最常受侵犯的脏器，有时为首发症状，肾脏病理改变可作为观察全身病变性质及程度的一个窗口。
|
[
{
"id": 0,
"entity": "结缔组织病",
"start_offset": 2,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "肾脏",
"start_offset": 7,
"end_offset": 9,
"label": "bod"
},
{
"id": 2,
"entity": "系统性红斑狼疮",
"start_offset": 10,
"end_offset": 17,
"label": "dis"
},
{
"id": 3,
"entity": "结缔组织病",
"start_offset": 20,
"end_offset": 25,
"label": "dis"
},
{
"id": 4,
"entity": "肾脏",
"start_offset": 42,
"end_offset": 44,
"label": "bod"
}
] |
肾活检不仅能够了解病因，明确病理类型，而且还有选择治疗及判断预后的价值。
|
[
{
"id": 0,
"entity": "肾活检",
"start_offset": 0,
"end_offset": 3,
"label": "pro"
}
] |
因此结缔组织病应尽早行肾活检。
|
[
{
"id": 0,
"entity": "结缔组织病",
"start_offset": 2,
"end_offset": 7,
"label": "dis"
},
{
"id": 1,
"entity": "肾活检",
"start_offset": 11,
"end_offset": 14,
"label": "pro"
}
] |
7.肾移植肾移植后发生肾功能减退的原因很多，临床鉴别十分困难。
|
[
{
"id": 0,
"entity": "肾移植",
"start_offset": 2,
"end_offset": 5,
"label": "pro"
},
{
"id": 1,
"entity": "肾移植",
"start_offset": 5,
"end_offset": 8,
"label": "pro"
},
{
"id": 2,
"entity": "肾功能减退",
"start_offset": 11,
"end_offset": 16,
"label": "sym"
}
] |
因此，当存在以下疑问时，应尽早行肾活检明确引起肾功能减退的原因：①肾移植后出现急性肾衰竭者；②移植后患者发热、尿量减少、血尿素氮及肌酐轻度升高、不能区分感染或排异反应者；③发生严重的排异反应，判断继续保守疗法或手术切除有困难者；④术后出现持续性蛋白尿，要明确是原有肾脏疾病复发还是其他因素引起者。
|
[
{
"id": 0,
"entity": "肾活检",
"start_offset": 16,
"end_offset": 19,
"label": "pro"
},
{
"id": 1,
"entity": "肾功能减退",
"start_offset": 23,
"end_offset": 28,
"label": "sym"
},
{
"id": 2,
"entity": "肾移植",
"start_offset": 33,
"end_offset": 36,
"label": "pro"
},
{
"id": 3,
"entity": "急性肾衰竭",
"start_offset": 39,
"end_offset": 44,
"label": "dis"
},
{
"id": 4,
"entity": "移植",
"start_offset": 47,
"end_offset": 49,
"label": "pro"
},
{
"id": 5,
"entity": "发热",
"start_offset": 52,
"end_offset": 54,
"label": "sym"
},
{
"id": 6,
"entity": "尿量减少",
"start_offset": 55,
"end_offset": 59,
"label": "sym"
},
{
"id": 7,
"entity": "血尿素氮及肌酐轻度升高",
"start_offset": 60,
"end_offset": 71,
"label": "sym"
},
{
"id": 8,
"entity": "不能区分感染或排异反应",
"start_offset": 72,
"end_offset": 83,
"label": "sym"
},
{
"id": 9,
"entity": "保守疗法",
"start_offset": 100,
"end_offset": 104,
"label": "pro"
},
{
"id": 10,
"entity": "手术切除",
"start_offset": 105,
"end_offset": 109,
"label": "pro"
},
{
"id": 11,
"entity": "术后出现持续性蛋白尿",
"start_offset": 115,
"end_offset": 125,
"label": "sym"
},
{
"id": 12,
"entity": "肾脏疾病",
"start_offset": 132,
"end_offset": 136,
"label": "dis"
}
] |
8.慢性小管间质性疾病慢性小管-间质性肾炎既可以是先天性、遗传性的，也可以是特发性或继发性的，其临床表现多种多样，包括蛋白尿、血尿、无症状性脓尿或原因不明的肾功能减退及由此引起的与慢性肾炎相似的各种临床表现，肾活检有助于明确诊断，探讨病因。
|
[
{
"id": 0,
"entity": "慢性小管间质性疾病",
"start_offset": 2,
"end_offset": 11,
"label": "dis"
},
{
"id": 1,
"entity": "慢性小管-间质性肾炎",
"start_offset": 11,
"end_offset": 21,
"label": "dis"
},
{
"id": 2,
"entity": "蛋白尿",
"start_offset": 59,
"end_offset": 62,
"label": "sym"
},
{
"id": 3,
"entity": "血尿",
"start_offset": 63,
"end_offset": 65,
"label": "sym"
},
{
"id": 4,
"entity": "无症状性脓尿",
"start_offset": 66,
"end_offset": 72,
"label": "sym"
},
{
"id": 5,
"entity": "肾",
"start_offset": 78,
"end_offset": 79,
"label": "bod"
},
{
"id": 6,
"entity": "慢性肾炎",
"start_offset": 90,
"end_offset": 94,
"label": "dis"
},
{
"id": 7,
"entity": "肾活检",
"start_offset": 104,
"end_offset": 107,
"label": "pro"
}
] |
第十八章重症肌无力重症肌无力（myastheniagravis，MG）包括三种综合征即新生儿MG、先天性MG及儿童MG，其中新生儿及儿童MG是一种发生在神经-肌肉接头处，乙酰胆碱受体（acetycholinereceptor，AChR）抗体介导、细胞免疫依赖的获得性自身免疫性疾病。
|
[
{
"id": 0,
"entity": "重症肌无力",
"start_offset": 4,
"end_offset": 9,
"label": "dis"
},
{
"id": 1,
"entity": "重症肌无力",
"start_offset": 9,
"end_offset": 14,
"label": "dis"
},
{
"id": 2,
"entity": "myastheniagravis",
"start_offset": 15,
"end_offset": 31,
"label": "dis"
},
{
"id": 3,
"entity": "MG",
"start_offset": 32,
"end_offset": 34,
"label": "dis"
},
{
"id": 4,
"entity": "新生儿MG",
"start_offset": 43,
"end_offset": 48,
"label": "dis"
},
{
"id": 5,
"entity": "先天性MG",
"start_offset": 49,
"end_offset": 54,
"label": "dis"
},
{
"id": 6,
"entity": "儿童MG",
"start_offset": 55,
"end_offset": 59,
"label": "dis"
},
{
"id": 7,
"entity": "儿童MG",
"start_offset": 66,
"end_offset": 70,
"label": "dis"
},
{
"id": 8,
"entity": "神经",
"start_offset": 76,
"end_offset": 78,
"label": "bod"
},
{
"id": 9,
"entity": "肌肉",
"start_offset": 79,
"end_offset": 81,
"label": "bod"
},
{
"id": 10,
"entity": "乙酰胆碱受体",
"start_offset": 85,
"end_offset": 91,
"label": "bod"
},
{
"id": 11,
"entity": "acetycholinereceptor",
"start_offset": 92,
"end_offset": 112,
"label": "bod"
},
{
"id": 12,
"entity": "AChR",
"start_offset": 113,
"end_offset": 117,
"label": "bod"
},
{
"id": 13,
"entity": "获得性自身免疫性疾病",
"start_offset": 130,
"end_offset": 140,
"label": "dis"
}
] |
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