| 老年药物相关性急性肾衰竭临床表现及病理分析 |
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| 引用本文： | 赵翠霞,王廉一,史晓虎,李文歌,杨冠男,方静,邹古明.老年药物相关性急性肾衰竭临床表现及病理分析[J].中国医院用药评价与分析,2011(8):741-744. |
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| 作者姓名： | 赵翠霞 王廉一 史晓虎 李文歌 杨冠男 方静 邹古明 |
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| 作者单位： | 中日友好医院肾内科;新疆医科大学附属中医医院老年病科;清华大学附属第一医院心脏中心超声科; |
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| 摘 要： | 目的:探讨老年药物相关性急性肾衰竭的临床表现、病理特点及相关药物。方法:回顾分析2005年1月—2010年3月在中日友好医院进行了肾穿刺的21例老年药物相关性急性肾衰竭患者的临床表现、肾脏病理、治疗与预后,以及导致急性肾衰竭的药物。结果:21例患者出现少尿6例,无尿3例,尿量正常12例;镜下血尿7例,无肉眼血尿;出现无菌性白细胞尿3例;24 h尿蛋白定量≤1.0 g者5例,1.0～3.5 g者11例,≥3.5 g者5例;患病前肾功能正常9例、轻度肾衰竭3例、不详9例,入院时血清肌酐为(597.9±426.7)μmol.L-1;入院时B超检查示:肾脏大小正常17例、增大4例。肾穿刺活检肾脏病理示:急性肾小管间质肾炎10例,亚急性肾小管间质肾炎3例,慢性肾小管间质肾病2例,特发性膜性肾病合并急性肾小管间质肾炎2例、不典型膜性肾病合并急性肾小管间质肾炎1例I、gA肾病合并急性肾小管间质肾炎2例,糖尿病肾病合并急性肾小管间质肾炎1例。出院时血清肌酐为(191.7±106.8)μmol.L-1,无1例死亡。可能导致急性肾衰竭的药物包括:抗生素、中成药、非甾体抗炎药、血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体阻断剂、保健品、抗结核药等。结论:老年人是药物相关性急性肾衰竭的高危人群,易导致肾损害的药物较多,老年人在服用常用药物尤其是服用多种药物时,也可导致急性肾衰竭。若能早期发现肾损害,及时诊治,多数患者预后良好,但患病前已存在慢性肾脏病的患者,急性肾衰竭多较重,可转为慢性肾衰竭。
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| 关 键 词： | 老年 药物 急性肾衰竭 肾脏病理 |
Clinical Manifestation and Pathology of Drug-related Acute Renal Failure in Elder Patients |
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| ZHAO Cui-xia,WANG Lian-yi,SHI Xiao-hu,LI Wen-ge,YANG Guan-nan,FANG Jing,ZOU Gu-ming.Clinical Manifestation and Pathology of Drug-related Acute Renal Failure in Elder Patients[J].Evaluation and Analysis of Drug-Use in Hospital of China,2011(8):741-744. |
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| Authors: | ZHAO Cui-xia WANG Lian-yi SHI Xiao-hu LI Wen-ge YANG Guan-nan FANG Jing ZOU Gu-ming |
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| Institution: | ZHAO Cui-xia1,2,WANG Lian-yi3,SHI Xiao-hu1,LI Wen-ge1,YANG Guan-nan1,FANG Jing1,ZOU Gu-ming1(1.Dept. of Nephrology,China-Japan Friendship Hospital,Beijing 100029,China,2.Dept. of Geratology,Hospital of Traditional Chinese Medicine Affiliated to Xinjiang Medical University,Urumchi 830000,3.Dept. of Ultrasonography,Heart Center of First Hospital Affiliated to Tsinghua University,Beijing 100016,China) |
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| Abstract: | OBJECTIVE:To explore the clinical manifestation,pathological feature and the related drugs of drug-related acute renal failure in elder patients.METHODS:A total of 21 elder patients who underwent renal puncture in China-Japan Friendship Hospital from January 2005 to March 2010 were reviewed with regard to clinical manifestations,renal pathology,treatment,prognosis,and the drugs involved in acute renal failure.RESULTS:Of the 21 cases reviewed,oliguria was noted in 6,anuria was noted in 3 and normal urinary v... |
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| Keywords: | Elder Drugs Acute renal failure Renal pathology |
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