药物过敏反应致急性肾衰竭老年患者的临床研究.docVIP

药物过敏反应致急性肾衰竭老年患者的临床研究 【摘要】目的 探讨药物过敏反应致急性肾衰竭(ARF)老年患者的特点和预后。方法 选择2011年1月—2014年1月本院药物过敏反应致ARF老年患者39例（观察组），随机选择同期中青年药物过敏反应致ARF患者48例作为对照组。观察两组治疗基本情况及预后结果，并分析两组治疗前后血清肌酐（Scr）、血尿素氮（BUN）、内生肌酐清除率（Ccr）水平。采用APACHE-Ⅱ评分对评估两组患者治疗后病情状况。结果 观察组少尿性ARF、血液透析、转为慢性肾功能衰竭和病死率分别为53.85%（21/39）、35.90%（14/39）、20.51%（8/39）和12.82%（5/39），均高于对照组27.08%（13/48）、16.67%（8/48）、6.25（3/48）和0.00（0/48）（P＜0.05）；观察组APACEE-Ⅱ评分为20.67±1.26，高于对照组13.81±1.04（P＜0.05）。观察组住院时间为17.68±1.53d，高于对照组12.92±1.08，差异均具有统计学意义（P＜0.05）。两组Scr、Ccr和BUN治疗后与治疗前比较，差异均具有统计学意义（P＜0.05）；观察组治疗后Scr、Ccr和BUN分别为113.95±12.13μmol/L、63.08±5.74 ml/min和7.30±1.61 mmol/L，对照组分别为149.12±14.06μmol/L、48.13±5.21ml/min和13.26±1.42mmol/L，差异均具有统计学意义（P＜0.05）。结论 老年患者是药物过敏反应致ARF 的高危人群，病情恢复缓慢，且预后差。 【关键词】药物过敏；急性肾衰竭；老年患者 The clinical study of patients with acute renal failure patients induced allergic reaction [Abstract] objective To explore the characteristics and prognosis for the elderly patients with acute renal failure (ARF)induced allergic reaction. Methods 39 elderly patients with ARF caused drug allergy reaction in our hospital from January in 2011 to January in 2014 (observation group).48 adults and young patients with ARF induced drug allergic reaction were selected randomly as the control group during the same period. To observe the basic treatment situation and outcomes in the two groups, and analyze of serum creatinine(Scr),blood urea nitrogen (BUN) and creatinine clearance rate (Ccr) level in two groups before and after treatment.Using APACHE-Ⅱassessment of scoring on patients condition of two groups after treatment. Results The oliguria ARF, hemodialysis, turn for chronic renal failure and mortality rates of the observation group were 53.85% (21/39), 35.90% (14/39), 20.51% (8/39) and 12.82% (5/39), higher than the control group 27.08% (13/48), 16.67% (8/48), 6.25 (3/48) and 0 (0/48) (P＜0.05).APACEE- II score of the observation group was 20.67 ± 1.26, higher than that of the control group 13.81 ± 1.04 (P＜0.05). The hospital stayobservation group was 17