文献报道的替加环素诱发肾移植患者急性胰腺炎11例分析

Literature Analysis of 11 Cases of Tigecycline-induced Acute Pancreatitis in Renal Transplant Patients

目的:探究文献报道的替加环素致肾移植术后患者急性胰腺炎的特点,为肾移植术后患者使用替加环素的安全提供参考。方法:检索国内外数据库中收录的替加环素诱发肾移植术后患者急性胰腺炎的个案报道,对纳入文献中患者基本信息及出现不良反应(ADR)情况进行统计分析。结果:共纳入11个病例,其中男8例,女3例,平均年龄(42.82±11.36)岁;10例患者合并使用免疫抑制药;9例(81.82%)患者的ADR诱导期在10d以内,8例(72.73%)患者初期临床表现主要是腹痛,6例(54.54%)为恶心、呕吐、腹胀;除1例未报道外,其他患者的血清淀粉酶和脂肪酶均高于正常值。所有患者均停药、对症处理,(3.56±1.26)d后临床症状逐渐改善,(6.3±5.06)d后血清淀粉酶和脂肪酶水平恢复正常。结论:肾移植术后患者使用替加环素应慎重,一旦发生急性胰腺炎需立即停药并对症处理。

Objective:To explore the regularity of acute pancreatitis in patients after kidney transplantation induced by tigecycline in case literature,and to provide reference for the safety and rationality of using tigecycline renal transplant patients.Methods:Case reports of tigecycline-induced acute pancreatitis in renal transplant patients were retrieved from domestic and foreign databases.The basic information of patients in the included literature and the occurrence of ADR were statistically analyzed.Results:A total of 11 patients were enrolled,including 8 males and 3 females,with an average age of(42.82±11.36)years.Ten patients were combined with immunosuppressive drugs.The induction period of ADR was within 10 days in 9 patients(81.82%),the primary clinical manifestations of 8 patients(72.73%)were abdominal pain,and 6 patients(54.54%)were nausea,vomiting and abdominal distension.Except one case,serum amylase and lipase were higher than normal.All patients stopped taking medicine and received symptomatic treatment.After(3.56±1.26)days,the clinical symptoms gradually improved,and the serum amylase and lipase levels returned to normal after(6.3±5.06)days.Conclusion:Tigecycline should be used with caution after renal transplantation.In case of adverse reaction of tigecycline-induced acute pancreatitis,the drug should be stopped immediately and treated according to the symptoms.