静脉滴注丙氨酰谷氨酰胺致血清尿素升高

1例93岁女性患者因反复呕吐、进食困难入院，肾功能检查示血清肌酐90μmol／L，尿素10mmol／L。给予复方氨基酸注射液500ml和丙氨酰谷氨酰胺注射液100ml静脉滴注，1次／d。入院第5天患者血清肌酐122μmol／L，尿素51mmol／L，未予特殊处理。第12天血清肌酐120μmol／L，尿素62mmol／L，K＋6．0mmol／L，Na＋157mmol／L，C1-134mmol／L。患者出现神志模糊。停用复方氨基酸和丙氨酰谷氨酰胺注射液，同时控制钾、钠和补液量。4d后因患者病情再次给予肠外营养液，但仪静脉滴注复方氨基酸注射液500ml／d，共1周。复查血清肌酐126μmol／L，尿素29．7mmol／L。此后患者尿素水平未再升高。

Elevated serum urea following intravenous infusion of alanyl glutamine

A 93-year-old woman was hospitalized with repeated vomiting and difficulty in eating. Renal function test showed the following results： creatinine （Cr） 90μmol/L,blood urea nitrogen （BUN） 10 mmol/L. An IV infusion of amino acid compound injection 500 ml and alanyl glutamine injection 100 ml were given once daily. On day 5 after administration, the renal function test showed the following results： Cr 122 μmol/L,BUN 51 mmol/L. No special treatment was given. On day 12 after administration, laboratory tests revealed the following levels： Cr 120 μmol/L, BUN 62 mmol/L, K＋ 6.0 mmol/L,Na＋ 157 retool/L, C1 134 mmol/L. The patient developed mental confusion. Amino acid compound injection and alanyl glutamine injection were stopped. The supplement volume of potassium, sodium, and fluid were adjusted at the same time. Four days later, the patient received parenteral-nutrition solution again due to her condition. An IV infusion of only amino acid compound injection 500 ml once daily was given for one week. Laboratoryreview showed the following results ： Cr 126 μmol/L, BUN 29.7 mmol/L. Henceforth, her BUN level did not increase again.