1例慢性肾功能不全患者应用硫唑嘌呤后出现骨髓抑制的药学监护

1例37岁慢性肾功能不全女性患者,因出现骨髓抑制症状入院,既往合并IgA肾病、痛风。入院后给予升高白细胞、纠正贫血等恢复骨髓功能的治疗措施,醋酸泼尼松控制IgA肾病及抗痛风等治疗。在治疗过程中,临床药师协助医生分析患者发生骨髓抑制的原因,评估并优化其免疫抑制治疗方案,在患者发生促红细胞生成素相关高血压时与医生充分沟通并提出合理的用药建议。治疗后患者骨髓抑制症状好转,病情得以控制出院。

Pharmaceutical care on a patient with chronic renal insufficiency and bone marrow suppression after application of azathioprine

One 37-year-old female patient with chronic renal insufifciency and combined by IgA nephropathy and gout was admitted to the hospital due to bone marrow suppression. After admission, several treatments were applied including the recovery of bone marrow function with the rise of white blood cells and the correction of anemia, prednisone acetate was used to control IgA nephropathy and antigout. During the treatment, clinical pharmacist assisted physicians to analyze the reasons of bone marrow suppression, evaluate and optimize immunosuppressive therapy. In cases of erythropoietin-related hypertension, clinical pharmacist communicated with physicians and gave rational suggestions about drug utilization. The patient＆#39;s condition was stable and he was discharged from hospital.