秋水仙碱致肾功能不全患者神经肌病1例并文献复习

A case report of neuromyopathy in a patient with renal insufficiency induced by colchicine and literature review

目的以病例为基础,分析秋水仙碱致肾功能不全患者神经肌病的临床特点、危险因素及诊治方案。方法对1例肾功能不全患者应用秋水仙碱治疗痛风致神经肌病的病例进行分析,并对相关文献进行复习。结果1例76岁男性肾功能不全患者因痛风服用秋水仙碱后,出现四肢无力、颤抖和肌酸激酶明显升高,考虑秋水仙碱导致的神经肌病,给予停用秋水仙碱和康复治疗后,患者肌无力症状好转,肌酸激酶恢复正常。结论秋水仙碱治疗过程中,临床药师或医师应详细询问患者的疾病史或既往用药史,对于有神经肌病高危因素的患者,谨慎选用秋水仙碱;如需选用,尽量小剂量应用,并监测患者肌酸激酶等。发生秋水仙碱神经肌病的患者,应及时停药,以免发生严重后果。

Objective To analyze the clinical characteristics,risk factors,diagnosis and treatment of colchicine-induced neuromyopathy in patients with renal insufficiency based on case report.Methods A case of colchicine-induced neuromyopathy of a renal insufficiency patient with gout was analyzed,and the related literatures were reviewed.Results A 76-year-old male patient with renal insufficiency developed limb weakness,tremor and a significant increase in creatine kinase after taking colchicine for gout.Neuromyopathy caused by colchicine was considered.After withdrawal of colchicine and rehabilitation treatment,the patient's myasthenia was improved and creatine kinase returned to normal.Conclusion During the treatment with colchicine,clinical pharmacists or physicians should inquire the patient's medical history or past medication history in detail.For the patients with high-risk factors of neuromyopathy,colchicine should be used with caution.In the case of using it as a must,the dose should be as low as possible,and the patient's creatine kinase should be monitored.Patients with colchicine neuromyopathy should stop the drug in time to avoid serious consequences.