阿帕替尼致高血压、肾病综合征1例

A case of hypertension and nephrotic syndrome induced by apatinib

1例72岁男性高血压患者,既往血压控制良好。因诊断晚期肺鳞癌,于2018年5月4日开始院外口服阿帕替尼片(250 mg,qd)治疗。6 d后出现血压升高,2018年6月14日为进一步检查及治疗入院。入院后查血压:167/97 mm Hg,血清白蛋白23.9 g·L-1,肌酐143.6μmol·L-1,尿素7.11 mmol·L-1,血脂正常,24小时尿蛋白检测:11.86 g。考虑阿帕替尼可能导致高血压、肾病综合征,给予停药、降压、降蛋白尿等对症治疗,患者血压恢复正常;1个月后复查:血清白蛋白30.9 g·L-1,肌酐106.6μmol·L-1;24小时尿蛋白检测:3.65 g。

A 72-year-old male patient with hypertension had a good blood pressure control in the past.The patient took apatinib(250 mg·d-1,qd)for advanced squamous cell lung cancer on May 4 th,2018 and developed elevated blood pressure six days later.So the patient was admitted to the hospital for further treatment on June 14 th,2018.Examination results after admission were as follows:blood pressure:167/97 mm Hg;serum albumin:23.9 g·L-1;serum creatinine:143.6μmol·L-1;urea nitrogen:7.11 mmol·L-1;blood lipid:normal;24-hour urinary protein:11.86 g.Hypertension and nephrotic syndrome induced by apatinib was considered.So apatinib was stopped and systematic treatments including reducing blood pressure and urine protein were given to him.And then,the blood pressure returned to normal.Examination results a month later were as follows:serum albumin:30.9 g·L-1;serum creatinine:106.6μmol·L-1;24-hour urinary protein:3.65 g.