甘露醇致急性肾功能衰竭18例分析

CLINICAL ANALYSIS OF 18 CASES OF ACUTE RENAL FAILURE INDUCED BY MANNITOL

目的 了解甘露醇在治疗脑卒中患者过程中的肾毒性。方法 观察489例脑卒中患者使用甘露醇治疗后尿量，尿常规，尿素氮，肌酐等变化。确定有否急性肾衰及与用药时间和剂量之间的相关性。结果 18例患者在用甘露醇治疗过程中发生了急性肾衰，发生率为3.7%。发生时间于用药后3-7d。发生类型均为少尿型，甘露醇剂量平均为（223±49)g/d，总用量为91086±242）g。结论 甘露醇引起急性肾衰与用药的时间和剂量呈正相关。合并高血压，糖尿病，动脉硬化的老年患者更易出现急性肾衰。

Objective\ To investigate the renal toxicity of mannitol in the cerebral apoplexy therapy.Methods\ Urine volume,urine routine test,BUN,Cr from 489 patients with cerebral apoplexy treated by mannitol were measured in order to find whether mannitol would cause acute renal failure (ARF) and the correlation of the fiming and dosage of mannitol with ARF.Results\ ARF occurred in 18 patients(3.7%) and all were uropenia renal failure.The most cases of ARF happened after the medication 3～7 days,and the average dosage was (223±49) g/d,the total dosage was (1 086±242) g.Conclusion\ There is a correlation between the dosage and fiming of mannitol with the occurrence of ARF.Advanced age,Hypertension,diabetes mellitus arterosclerotic are all high risk factors for ARF.