85例抗菌药物致药源性肾损伤分析

Analysis on 85 Cases of Drug-Induced Renal Injury Induced by Antibiotics

目的:探讨抗菌药物致药源性肾损伤的情况及其转归。方法:回顾性分析2016—2018年湖南省人民医院收治的85例使用抗菌药物出现药源性肾损伤患者的临床资料,分析引发肾损伤的抗菌药物种类,总结药学监护方法。结果:85例出现药源性肾损伤的患者中,男性53例(占62.35%),女性32例(占37.65%);年龄4~88岁,平均(45.9±18.7)岁,≥60岁的老年患者为高发人群。致肾损伤病例数排序居前4位的抗菌药物类别分别为氨基糖苷类(24例,占28.24%)、氟喹诺酮类(18例,占21.18%)、β-内酰胺类(15例,占17.65%)和糖肽类(8例,占9.41%);静脉滴注(77例,占90.59%)是引起药源性肾损伤的主要途径。治愈42例(占49.41%),好转35例(占41.18%),持续6例(占7.06%),有后遗症2例(占2.35%)。结论:合理应用抗菌药物、建立有效的药学监护系统,有利于减少药源性肾损伤,进一步提高抗菌药物的用药安全性。

OBJECTIVE:To probe into drug-induced renal injury induced by antibiotics and its outcome.METHODS:Clinical data of 85 cases of drug-induced renal injury induced by antibiotics in People's Hospital of Hunan Province during 2016-2018 were retrospectively analyzed in terms of the categories of antibiotics,so as to summarize pharmaceutical care methods.METHODS:Among the 85 cases of drug-induced renal injury,53 cases were male(62.35%),32 cases were female(37.65%);aged between 4-88,with an average of 45.9±18.7 years old,people aged≥60 were high-risk group.The top 4 antibiotics sorted by the cases of drug-induced renal injury were respectively aminoglycosides(24 cases,28.24%),fluoroquinolones(18 cases,21.18%),β-lactam antibiotics(15 cases,17.65%)and glycopeptides(8 cases,9.41%);intravenous drip(77 cases,90.59%)was the main route leading to drug-induced renal injury.42 cases(49.41%)were cured,35 cases(41.18%)were improved,6 cases(7.06%)were sustained,2 case(2.35%)had sequelae.CONCLUSIONS:Rational application of antibiotics and establishment of an effective pharmaceutical care system are conducive to reducing drug-induced renal injury and further improving the medication safety of antibiotics.