药物致急性肾功能衰竭285例文献分析

Drug-induced Acute Renal Failure:Analysis of 285 Cases

目的:了解药物致急性肾功能衰竭(ARF)的发生情况及临床特点。方法:检索到中国生物医学文献数据库及中国医院数字图书馆期刊全文库(1995年1月～2007年12月)药物所致ARF285例,并进行统计、分析。结果:药物致ARF285例中,男性186例,女性99例;引起ARF的常见药物达50种,发生例数最多的依次为甘露醇、阿昔洛韦、多巴胺、利福平、庆大霉素、右旋糖酐40等;静脉滴注引发ARF242例,占84.91%;出现ARF的时间以用药后1～5d最多;治愈251例(占88.07%),好转6例(占2.11%),自动出院5例(占1.75%),4例转为慢性肾功能衰竭(占1.40%),死亡24例(占8.42%)。结论:各种给药方法及许多常用药物均可致ARF,且发病率日益增多,但只要诊断及时、准确,治疗恰当,大多预后良好。

OBJECTIVE： To investigate the clinical feature of drug- induced acute renal failure （ARF）. METHODS： 285 ARF cases retrieved from CBMdisc and CNKI between Jan. 1995 and Dec. 2007 were analyzed statistically. RESULTS： Of the 285 drug- induced ARF cases reviewed, 186 were male and 99 female. The drugs induced ARF totalled 50 kinds, leading the list in order were mannitol, acyclovir, dopamine, rifampicin, gentamicin, and dextran 40 etc; 242 （84.91%） received medicine by intravenous drip route. ARF appeared more often from day 1 to 5 after drug use; 251 were cured （88.07%）, 6 took a favorable turn （2.11% ）, 5 discharged from hospital automatically （ 1.75% ）, 4 developed chronical renal failure （ 1.40% ） and 24 died （8.42%） . CONCLUSION： Lots of medicines and common drugs can induce ARF, with incidence rate of drug-induced ARF increased increasingly, however, which has a satisfactory prognosis if with timely and accurate diagnosis and suitable treatment.