恶性高血压所致血栓性微血管病发展为 慢性肾功能衰竭一例并文献复习
A Case of Chronic Renal Failure Resulting from Thrombotic Microangiopathy Induced by Malignant Hypertension and Literature Review
摘要: 血栓性微血管病变(Thrombotic microangiopathies, TMA)是一组以微血管病变性溶血性贫血、血小板减少及微循环血栓导致的器官损伤为特征的临床综合征，而恶性高血压是TMA的一种诱因，因TMA病情错综复杂，进展迅速，肾脏预后较差，尤其是恶性高血压所致的TMA的肾脏损伤更为明显，若不及时救治，病死率高及进展为肾衰竭的可能性大。本文报道了一例恶性高血压引起的血栓性微血管病并最终进展为慢性肾功能衰竭的病例，并进行相关文献复习，了解此病的临床特征、发病机制、鉴别诊断及治疗与预后，旨在提高临床医师对于本病的认识以及争取做到早诊断、早治疗，加强检测手段，及时调整治疗措施，从而进一步改善预后情况。
Abstract: Thrombotic microangiopathies (TMA) are a group of clinical syndromes characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ damage caused by microcirculatory thrombosis. Malignant hypertension is one of the triggering factors for TMA. Given the complex nature and rapid progression of TMA, renal prognosis is generally poor, particularly in cases induced by malignant hypertension, where renal injury is more pronounced. Without timely intervention, the condition carries a high mortality risk and a significant likelihood of progressing to renal failure. This article reports a case of thrombotic microangiopathy caused by malignant hypertension that ultimately advanced to chronic renal failure. A review of relevant literature was conducted to understand the clinical features, pathogenesis, differential diagnosis, treatment, and prognosis of this disease. The aim is to enhance clinicians’ awareness, promote early diagnosis and treatment, strengthen monitoring measures, and timely adjust therapeutic strategies to further improve patient outcomes.
文章引用：杨晓雨, 栾弘. 恶性高血压所致血栓性微血管病发展为 慢性肾功能衰竭一例并文献复习[J]. 临床医学进展, 2026, 16(2): 2137-2143. https://doi.org/10.12677/acm.2026.162612

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