穿心莲内酯注射液致急性肾衰竭2例

Acute renal failure induced by andrographolide injection:two case reports

2例男性患者静脉滴注穿心莲内酯注射液后出现肾衰竭。例1为29岁男性患者,因发热给予静脉滴注穿心莲内酯0.5g。输液结束后,随即出现腰痛。当天晚上,患者SCr为142μmol/L。第2天入院,其SCr为219μmol/L。住院第2天,SCr为332μmol/L。诊断为急性肾衰竭。给予补液和对症治疗。3d后,患者SCr下降至244μmol/L,住院第7天,SCr降至149μmol/L。患者住院9d后出院,腰部疼痛消失。出院10d后随访,肾功能正常。例2为25岁男性患者,因感冒给予穿心莲内酯0.25g静脉滴注,并口服阿奇霉素0.25g。滴注约4h,患者出现腰痛。第2天,患者SCr为189.7μmol/L,BUN为8.89μmol/L。停用所有药物,第3天患者持续腰痛,SCr214μmol/L,BUN8.8μmol/L。给予支持治疗后,SCr降至138μmol/L,BUN降至6.4μmol/L。出院1周后随访,患者肾功能恢复正常。

Two male patients developed acute renal failure after receiving an IV infusion of andrographolide injection. The first patient, a 29-year-old patient, received an IV infusion of andrographolide 0.5 g for a fever. He developed lumbago after the infusion. His SCr was 142 μmol/L in the evening at that day. The next day, he was hospitalized and his SCr was 219 μmol/L. On day 2 of hospitalization, the patient＇s SCr was 332 μmol/L. Acute renal failure was diagnosed. Fluid replacement and symptomatic therapy were given. Three days later, his SCr decreased to 244 μmol/L. On day 7 of hospitalisation, his SCr decreased to 149 μmol/L. After 9 days of hospilisation, the patient was discharged, and his lumbago disappeared. A follow-up 10 days after discharge, his renal function normalized. The second patient, a 25-year-old man, received an IV infusion of andrographolide 0.25 g and oral azithromycin 0.25 g for a cold. After about 4 hours of the infusion, the patient developed lumbago. The next day, his SCr was 189.7 μmol/L and his BUN was 8. 89 μmol/L. All drugs were discontinued. On day 3, his lumbago persisted, his SCr was 214 μmol/L and his BUN was 8.8 μmol/L. After receiving supportive therapy, his SCr decreased to 138 μmol/L and his BUN decreased to 6.4 μmol/L. A follow-up one week after discharge, his renal function normalized.