终末期肾脏病患者应用头孢他啶后并发抗生素脑病的相关性分析

Correlation Analysis of the Patients with End Stage Renal Disease and Antibiotics Encephalopathy after Giving Ceftazidime

目的：探讨终末期肾脏病（ESRD）患者应用头孢他啶后并发抗生素脑病的相关性.方法：回顾性分析我院20例ESRD应用头孢他啶后并发抗生素脑病的患者资料,并作为观察组,同期选择20例ESRD应用头孢他啶后未并发抗生素脑病的患者资料作为对照组.观察组患者经停用头孢他啶2～5 d后,若未见好转,则进行血液透析串联血液灌流.监测观察组患者血红蛋白（Hb）、白蛋白（Alb）、血肌酐（Scr）、尿素氮（BUN）、总胆固醇（TC）、甘油三酯（TG）、甲状旁腺激素（PTH）水平,记录头孢他啶使用时间与累积剂量,并与对照组进行比较.结果：观察组患者的年龄、头孢他啶使用时间、头孢他啶累积剂量均显著高于对照组,Alb水平显著低于对照组,差异均有统计学意义（P〈0.05）.观察组患者经对症治疗后19例好转,1例死亡.结论：ESRD患者应用头孢他啶后并发抗生素脑病与患者高龄、低Alb血症、头孢他啶使用时间及累积剂量具有相关性.

OBJECTIVE：To investigate the correlation of patients with end stage renal disease（ESRD）and antibiotics encepha-lopathy after giving ceftazidime. METHODS：Data of 20 ESRD patients with antibiotics encephalopathy were retrospectively ana-lyzed and included into observation group,and also 20 ESRD patients with no antibiotics encephalopathy were included into con-trol group. Patients with no improved conditions in observation group were given hemodialysis associated with hemoperfusion after 2-5 days of ceftazidime withdrawal. The hemoglobin（Hb）,albumin（Alb）,serum creatinine（Scr）,blood urea nitrogen（BUN）, total cholesterol（TC）,triglyceride（TG）,parathyroid hormone（PTH）,use time and cumulative dose of ceftazidime in observa-tion group were detected and compared with control group. RESULTS：The age,use time and cumulative dose of ceftazidime in ob-servation group were significantly higher than control group,Alb level was lower than control group,the differences were statisti-cally significant（P〈0.05）. 19 patients in remission and 1 died in observation group. CONCLUSIONS：The antibiotic encephalopa-thy in ESRD patients has correlation with elderly,hypoalbuminemia,use time and cumulative dose of ceftazidime.