77例药物性肾损害病例分析.pdfVIP

案例分析 Case Analysis 77例药物性肾损害病例分析 * 高翔，陈杰 ，孙萍萍，夏延哲，闫佳佳，吴海燕，洪晓丹 中山大学附属第一医院 药学部，广州，510080 [摘要] 目的：探讨药物性肾损害的临床特点及预后，提高药物性肾损害的防治水平。方法：回顾性分析我院2011年2月至 2013年12月77例确诊为药物性肾损害住院患者的临床资料。结果：引起药物性肾损害药物主要为免疫抑制剂(24.7%) 、中药 (14.3%) 、造影剂(13%) 、非甾体抗炎药(11.7%) 、抗菌药(11.7%) 。77例药物性肾损害患者中，发生急性肾功能衰竭51例，慢性 肾功能衰竭20例，慢性肾功能衰竭急性加重6例；65例好转，1例死亡，好转率84%。结论：对于有肾损害危险因素的病人在应 用药物时应考虑各方面因素，密切观察用药后反应，监测尿常规、肾功能及尿量的变化。 [关键词] 药物性肾损害；病例分析；防治 [中图分类号] R97　　[文献标识码]　A　　[文章编号]　1672-2809(2015)18-0042-05 Drug-induced Renal Impairment: Clinical Analysis of 77 Cases * GAO Xiang, Chen Jie , SUN Ping-ping, XIAYan-zhe, YAN Jia-jia, WU Hai-yan, HONG Xiao-dan Department of Pharmacy, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, 510080 [Abstract] Objective: To investigate the clinical characteristics and prognosis of drug-induced renal impairment, thus improve the practice of prevention and treatment of it. Methods: 77 cases clinically diagnosed drug-induced renal impairment, were analyzed retrospectively. Results: The drugs which commonly caused drug-induced renal impairment included immunosuppressive drugs (24.7%), traditional Chinese medicine (14.3%), contrast agents (13%), non steroidal anti-inflammatory drugs (11.7%) and antibiotics (11.7%). 51 patients developed acute renal failure, 20 patients were diagnosed chronic renal failure. Of 77 cases of drug-induced renal injury patients, 65 cases were improved, 1 case died, and the improvement rate was 84%. Conclusion:For patients at the risk of renal impairment, factors such as drug dosage, drug duration and pre-existing diseases should be taken into account, and patients should be monitored closely during drug therapies. [Key words] Drug-induced Renal Impairment; Case Analysis; Prophylaxis and Treatment 随着药物的不断开发及广泛应用，但医生 进行分析，以提高医务人员在临床实践中对药物性 和患者对药物联用以及不良反应知识掌 肾损害的认识，协助医生早期作出诊断治疗，改善 握的欠缺，不合理用药现象越来越常见，肾脏作为