住院患者硫酸依替米星治疗后发生急性肾损伤的影响因素分析(1)
[摘要] 目的 研究硫酸依替米星致药物性肾损害的危险因素，为临床合理应用硫酸依替米星提供参考依据，减少肾损害的发生。 方法 查询我院2014年1月～2015年12月期间住院使用硫酸依替米星患者病历，共计789例。筛除不合格病例，最终入选63例。根据阿姆斯特丹AKI诊断标准，按治疗前、后Scr结果将出现急性肾损伤患者分为1组(n=6)和未发生急性肾损患者为2组(n=57)。采用 SPSS 16.0软件进行统计分析。 结果 6例应用硫酸依替米星治疗后发生AKI的患者，各项指标变化差异均无统计学意义(P>0.05)。单因素分析显示高血压可能与应用依替米星治疗后致急性肾损伤相关(P<0.05)。 结论 硫酸依替米星为较为安全的氨基糖苷类抗菌药物，患有高血压的感染患者应用该药物时需加强肾功能监测。
[关键词] 依替米星；肾功能；药物性肾损害；急性肾损伤
[中图分类号] R969 [文献标识码] B [文章编号] 1673-9701(2016)20-0078-03
[Abstract] Objective To explore the risk factors for medical renal impairment induced by etimicin sulfate， so as to provide references for clinical rational application of etimicin sulfate and reduce renal impairment. Methods A total of 789 cases of medical records with the use of etimicin sulfate during hospitalization from January 2014 to December 2015 in our hospital were consulted. Unqualified medical records were screened out， and 63 cases were finally selected. According to Amsterdam AKI diagnostic criteria， the patients with acute renal impairment were assigned to group 1(n=6) and the patients with non-released acute renal impairment were assigned to group 2(n=57) via the Scr results before and after the treatment. SPSS16.0 software was applied for statistical analysis. The experiment results were represented by average number±standard deviation， and P<0.05 represented the differences were statistically significant. Results In the 6 patients with AKI induced by the etimicin sulfate therapy， the changes of each index were not statistically significant (P>0.05). According to the univariate analysis， hypertension might be associated with acute renal impairment induced by etimicin therapy (P<0.05). Conclusion Etimicin sulfate is a relatively safe aminoglycosides antibiotics. Renal function monitoring should be strengthened while the patients with hypertension and infection are using this drug.
[Key words] Etimicin； Renal function； Medical renal impairment； Acute renal impairment
氨基糖苷类抗生素依替米星与β内酰胺类抗生素有协同作用，与其他抗生素联合治疗重症感染有较好的临床疗效，且不易产生耐药[1-4]。其常见的不良反应为耳、肾不良反应，Ⅲ期临床试验结果显示其肾毒性发生率为1.3%[5，6]。目前血清肌酐(serum creatinine，Scr)水平为肾损伤诊断评价最常用的指标。本研究通过回顾性分析，研究硫酸依替米星导致的药物性肾损害的影响因素，为临床合理应用硫酸依替米星，减少其对肾脏的损害提供依据。
1 资料与方法
1.1 一般资料
选择我院2014年6月～2015年12月住院使用硫酸依替米星患者874例。筛除只有一次肾功能检查患者438例、疗程<2 d患者85例、用药前后超过2周进行肾功能检查以及病史不完整的病例288例，最终入选病例63例，其中男52例(82.54%)，女11例(17.46%)，年龄22～89岁，平均(74±17)岁，>75岁42例。92.1%(58/63)患者原发病为肺部感染，其他部位感染为7.9%(5/63)。合并基础疾病58例(92.06%)，高血压病37例(58.73%)，糖尿病14例(22.22%)，心脏病29例(46.03%)。对上述病例进行病史等基本情况检索，了解患者的临床特征、治疗资料、实验室检查、基础疾病等。, http://www.100md.com(宁微微 宗士香 朱军等)
[关键词] 依替米星；肾功能；药物性肾损害；急性肾损伤
[中图分类号] R969 [文献标识码] B [文章编号] 1673-9701(2016)20-0078-03
[Abstract] Objective To explore the risk factors for medical renal impairment induced by etimicin sulfate， so as to provide references for clinical rational application of etimicin sulfate and reduce renal impairment. Methods A total of 789 cases of medical records with the use of etimicin sulfate during hospitalization from January 2014 to December 2015 in our hospital were consulted. Unqualified medical records were screened out， and 63 cases were finally selected. According to Amsterdam AKI diagnostic criteria， the patients with acute renal impairment were assigned to group 1(n=6) and the patients with non-released acute renal impairment were assigned to group 2(n=57) via the Scr results before and after the treatment. SPSS16.0 software was applied for statistical analysis. The experiment results were represented by average number±standard deviation， and P<0.05 represented the differences were statistically significant. Results In the 6 patients with AKI induced by the etimicin sulfate therapy， the changes of each index were not statistically significant (P>0.05). According to the univariate analysis， hypertension might be associated with acute renal impairment induced by etimicin therapy (P<0.05). Conclusion Etimicin sulfate is a relatively safe aminoglycosides antibiotics. Renal function monitoring should be strengthened while the patients with hypertension and infection are using this drug.
[Key words] Etimicin； Renal function； Medical renal impairment； Acute renal impairment
氨基糖苷类抗生素依替米星与β内酰胺类抗生素有协同作用，与其他抗生素联合治疗重症感染有较好的临床疗效，且不易产生耐药[1-4]。其常见的不良反应为耳、肾不良反应，Ⅲ期临床试验结果显示其肾毒性发生率为1.3%[5，6]。目前血清肌酐(serum creatinine，Scr)水平为肾损伤诊断评价最常用的指标。本研究通过回顾性分析，研究硫酸依替米星导致的药物性肾损害的影响因素，为临床合理应用硫酸依替米星，减少其对肾脏的损害提供依据。
1 资料与方法
1.1 一般资料
选择我院2014年6月～2015年12月住院使用硫酸依替米星患者874例。筛除只有一次肾功能检查患者438例、疗程<2 d患者85例、用药前后超过2周进行肾功能检查以及病史不完整的病例288例，最终入选病例63例，其中男52例(82.54%)，女11例(17.46%)，年龄22～89岁，平均(74±17)岁，>75岁42例。92.1%(58/63)患者原发病为肺部感染，其他部位感染为7.9%(5/63)。合并基础疾病58例(92.06%)，高血压病37例(58.73%)，糖尿病14例(22.22%)，心脏病29例(46.03%)。对上述病例进行病史等基本情况检索，了解患者的临床特征、治疗资料、实验室检查、基础疾病等。, http://www.100md.com(宁微微 宗士香 朱军等)