药物性急性肾衰竭临床研究

目的：探讨药物所致急性肾衰竭（ARF）的病因、发生、临床病理改变、治疗及预后。方法：收集215例ARF患者,分析其发生率、预后及涉及药物种类。结果：药物性ARF患者86例占同期ARF（215例）患者的40%。其中急性肾小管坏死61例（70.9%）,急性间质性病变10例（11.6%）。涉及药物：氨基糖甙类抗生素为主要病因（40.7）,其次为β-内酰胺类抗生素（15.1%）,第三位为抗肿瘤药物（11.6%）。50例行血液透析治疗（58.1%）,治愈率69.7%,好转率11.6%,死亡率18.4%。结论：ARF病因以药物性因素占首位,抗生素仍为主要病因。早期预防与及时诊断是预后关键。

A clinical study of drug induced acute renal failure

Objective：To investigate the etiological factors,occurrence,clinical pathological change,therapy and prognosis of drag induced acute renal failure （ARF）. Methods：215 patients with ARF were collected, and the incidence,prognosis and the kinds of involved drug of ARF were analyzed. Results：There were 86 patients with drug induced ARF accounting for 40% among the contemporaneous 215 patients with ARF. There were 61 cases of acute tubular necrosis accounting for 70.9%, 10 cases of acute tubulointerstitisl lesions accounting for 11.6% among them. Involved drugs： aminoglycoside antibiotics （40.7%） was the first etiological factor for drug indaced ARF, the second was β-lactam antibiotics （15.1%）, the third was antitumor drugs （11.6%）. Hemodlalysis in 50 cases accounted for 58.1%,the cure rate was 69.7%,the improvement rate was 11.6% and the mortality was 18.4%. Conclusion：Drug is the chief cause of ARF. The incidence of ARF in mlddle-aged and old people is higher than that in young people. Antibiotics were the chief etiological factor of ARF. The key of prognosis of ARF is early prevention and timely diagnosis.