幽门螺杆菌根除治疗中应重视阿莫西林的肾脏损伤作用

Attention should be paid to the renal injury of amoxicillin in the eradication therapy of Helicobacter pylori

阿莫西林具有较强的杀菌能力,广泛应用于幽门螺杆菌感染的治疗。阿莫西林相关肾损伤的临床表现包括血尿、蛋白尿、少尿、无尿以及急性肾衰竭等。阿莫西林相关肾损伤的主要机制包括免疫系统的激活以及晶体性肾病两个方面,其中晶体性肾病的发生与用药剂量相关。由于近年来幽门螺杆菌根除治疗中大剂量阿莫西林的应用越来越多,阿莫西林相关急性肾损伤的发生率也越来越高。因此,应重视阿莫西林相关肾损伤,合理确定用药剂量和用药间隔,以更好地清除幽门螺杆菌、减少肾脏副作用。

Amoxicillin has a strong bactericidal activity and is widely used in the treatment of Helicobacter pylori infection.The clinical manifestations of amoxicillin-related renal injury include hematuria,proteinuria,oliguria,anuria,and acute renal failure.The main mechanisms of amoxicillin-related renal injury include the activation of immune system and crystal nephropathy.The occurrence of crystal nephropathy is related to the medication dose of amoxicillin.Due to the increasing application of high-dose amoxicillin in the radical treatment of Helicobacter pylori in recent years,the incidence of amoxicillin-related acute kidney injury has also increased.Therefore,attention should be paid to the amoxicillin-related renal injury,so that the dosage and interval of medication should be determined reasonably to better eliminate Helicobacter pylori and reduce the renal side effects.