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答:高热病人出现蛋白尿是经常遇到的,其病因需具体分析.蛋白尿的出现常常与引起发热的原因有关,既可能是功能性的,也可能是病理性的,就临床所见,前一种情况占多数.功能性蛋白尿发生机理大体有两种:(1)高热时肾血管痉挛或充血,从而使肾小球通透性增加,血浆蛋白滤出增多,超出肾小球的重吸收功能,使部分蛋白随尿液排出.(2)高热缺氧,代谢增加,耗氧也增加,使体内酸性代谢产物滞留,刺激肾脏,引起蛋白体溶解和肾小管重吸收蛋白的功能障碍,以及上皮细胞脱落,并形成管型进入尿中,形成蛋白尿及少许管型,这种蛋白尿的特点是尿中蛋白含量不高,少许管型及红、白细胞,且表现为一过性,热退后蛋白尿亦消失.例如重症肺炎、上感患者常出现.
A: High fever patients proteinuria is often encountered, the etiology of the need for a specific analysis of the occurrence of proteinuria and fever are often caused by the reasons, either functional or it may be pathological, as clinically seen, The former case accounted for the majority of functional proteinuria in general there are two mechanisms: (1) high-temperature renal vasospasm or congestion, so that increased glomerular permeability, increased plasma protein filtration beyond the glomerular Reabsorption function, so that part of the protein excreted with the urine. (2) hyperthermia and hypoxia, increased metabolism, increased oxygen consumption, the body acid metabolites stay, stimulate the kidneys, causing proteolysis and tubular reabsorption of protein dysfunction , As well as epithelial cells shedding, and the formation of tubular into the urine, the formation of proteinuria and a little tubular, this proteinuria is characterized by urinary protein content is not high, a little tubular and red, white blood cells, and showed a transient , Hot back proteinuria also disappeared, such as severe pneumonia, the patient often appear.