药物性肾损害的因素分析和防治探讨

Analysis of Factors Related to and Prophylactico-therapy of Drug-induced Renal Damage

目的 :探讨药物性肾损害的发病因素和防治措施。方法 :分析110例药物性肾损害患者原发病及应用肾毒性药物情况 ,并根据临床表现分为有急性肾衰 (ARF)和无ARF的血尿、蛋白尿2类损害。110例患者中有65例给予谷胱甘肽治疗 ,另45例作对照。治疗组ARF32例 ,对照组31例。结果 :110例患者中有49例 (47 2 % )应用2种以上肾毒性药物 ,有72例 (65 5 % )有发热或应用过抗生素、脱水剂。两组中对ARF治疗总有效率分别为90 6 %和64 5 % ,对无ARF的血尿、蛋白尿总有效率分别为84 8 %和57 2 % ,两组疗效比较有极显著性差异 (P<0 01)。结论 :联合应用和在有肾血流量不足情况下应用肾毒性药物是肾损害发生的重要因素 ;谷胱甘肽对药物性肾损害有明显的治疗效果。

AIM: To investigate the pathogenic factors and prevention and cure of drug-induced renal damageMETHODS:According to the clinical manifestations,110 cases of drug-induced renal damage were divided into two types∶one type had acute renal failure(ARF),another had hematuria and proteinuria but no ARFOf 110 cases,65(32 ARF)were treated with glutathione,45(31 ARF) as controlRESULTS:Of 110 cases,49(472%)had received more than two kinds of nephrotoxic agents,72(655%) had had fever and had received antibiotics or dehydrantsThe effective rates for ARF in above-mentioned two groups were 906% and 645% respectivelyThe effective rates for hematuria and proteinuria were 848% and 572% respectively with significant difference(P<001)CONCLUSION:Combined use of nephrotoxic agents or use of them in condition of insufficiant renal blood flow may play an important role in pathogenesis of renal damageGlutathione has marked therapeutic effect on drug-induced renal damage