硫酸依替米星氯化钠注射液致肾损害

Renal injury caused by etimicin sulfate and sodium chloride injection

患者,男性,57岁,因腹膜后纤维化、双肾积水、泌尿系感染等症,给予硫酸依替米星氯化钠注射液0.3 g静脉滴注,每天1次,连续用药9 d后,尿素氮由6.74 mmol.L-1上升至9.85 mmol.L-1,血清肌酐由103.0μmol.L-1升至373.9μmol.L-1。停药6 d后尿素氮降至5.11 mmol.L-1,血清肌酐降至122.1μmol.L-1。随后的20多天里,仍按上述方案间断使用该药,用药过程中尿素氮及血清肌酐随用药或停药而上升或下降。在停药2周并针对原发病治疗后尿素氮恢复至2.94 mmol.L-1,肌酐恢复至76.0μmol.L-1。调整给药方案为硫酸依替米星氯化钠注射液,静脉滴注,0.15 g,每天2次,连续使用6 d,尿素氮及血清肌酐未见明显升高。

One 57-year-old man with retroperitoneal fibrosis, bilateral hydronephrosis and urinary system infection was administrated with intravenous drop infusion of etimicin sulfate and sodium chloride injection 0.3 g once daily. Nine days later, his urea nitrogen increased from 6.74 mmol.L^-1 to 9.85 mmol-L^-1 and serum creatine increased from 103.0 μmol·L^-1 to 373.9 μmol·L^-1. Six days after etimicin withdrawal, his urea nitrogen decreased to 5.11 mmol.L1 and serum creatine decreased to 122.1 μmol·L^-1. About 20 days after etimicin withdrawal, etimicin sulfate and sodium chloride injection was given again intermittently, urea nitrogen and serum creatine increased or decreased following the etimicin administration or withdrawal. After 2 weeks withdrawal combined with original disease treatment, his urea nitrogen decreased to 2.94 mmol-L-~ and serum creatine decreased to 76.0 μmol·L^-1. And then the dosage regimen was regulated to intravenous drop infusion of etimicin sulfate and sodium chloride injection 0.15 g twice daily. After six days of continuous administration, his urea nitrogen and serum creatine did not increase obviously.