晚近已发现非类固醇抗炎药(non-steroidal anti-inflammatory drugs,NSAID)可诱致许多肾损害,如肾功能减退、间质性肾炎及肾乳头坏死等。NSAID也可引起轻微变化型肾病,但都同时并发间质性肾炎。作者报告1例应用甲苯酰吡咯乙酸(tolmetin)伴发的轻微变化型肾病综合征,而无并存的间质性肾炎。患者为女性,70岁,诊断为风湿性多发性肌痛症。用药前尿液及肾功能正常。用本药0.2g,每日3次,4个月后增至0.4g,每日3次,在增量后的第3周发生水肿和体重增加,伴大量蛋白尿、低蛋白血症及高脂血症。肾活检在光镜下未见异常,无间质炎症变化,免疫荧光观察未发现阳性;电镜仅显示弥漫性足 Recently, it has been found that non-steroidal anti-inflammatory drugs (NSAIDs) can cause many kidney damage, such as renal dysfunction, interstitial nephritis and renal papillary necrosis. NSAID can also cause mild changes in nephropathy, but both concurrent interstitial nephritis. The authors reported 1 case of mildly variant nephrotic syndrome associated with tolmetin, with no accompanying interstitial nephritis. The patient was female, age 70, diagnosed with rheumatic polymyositis. Urine and renal function before treatment is normal. The drug 0.2g, 3 times a day, 4 months later increased to 0.4g, 3 times a day, in the first 3 weeks after the increase in edema and weight gain, with a large number of proteinuria, hypoproteinemia and high Lipidosis. Renal biopsy showed no abnormalities under light microscope, no interstitial inflammatory changes, no positive immunofluorescence observation; electron microscopy showed only diffuse foot