| 111例马兜铃酸肾病调查分析 |
| 投稿时间：2023-08-31 修订日期：2023-10-16 点此下载全文 |
| 引用本文：史文慧,王艳梅,蒋黎,李俊,李晓萌,何志军.111例马兜铃酸肾病调查分析[J].药学实践杂志,2024,42(1):38~42 |
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| 中文摘要:目的 分析含有马兜铃酸成分的药物引起马兜铃酸肾病的临床特点和规律。方法 回顾性研究 111例服用含马兜铃酸成分的药物致肾损害患者的临床资料，分析马兜铃酸肾病的临床特点、服药及治疗方法等。结果 111例患者中，女性多于男性（2.58∶1），大于50岁的101例（90.99%）；年龄（63.70±11.67）岁；平均用药时间（8.08±6.94）年；涉及冠心苏合丸和龙胆泻肝丸共106例（95.50%）；血肌酐升高108例，尿素氮升高106例，血红蛋白降低103例，多见低比重尿、轻中度蛋白尿和潜血；B 超检查示肾脏均不同程度受损。肾脏病理活检为肾小管损害。多数患者起病隐匿，进展程度不一，与年龄、服药时间不成正比，临床上肾功能呈进行性损害, 多数不可逆、预后较差。结论 肾损害患者个体差异较大,肾损伤与服用马兜铃酸药物时间长短、剂量不平行；马兜铃酸肾病进展迅速，且停止服用含马兜铃酸药物后病情依然进展。加强药物警戒工作，实施早期的诊断和有效的干预，有助于减少马兜铃酸肾病的发生，延缓其发展。 |
| 中文关键词:马兜铃酸|马兜铃酸肾病|肾损害|冠心苏合丸|龙胆泻肝丸|药物警戒 |
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| Analysis of 111 cases of aristolochic acids nephropathy |
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| Abstract:Objective To analyze the clinical characteristics and regularity of aristolochic acid nephropathy (AAN) induced by drugs containing aristolochic acid. Methods The clinical data of 111 patients with AAN induced by aristolochic acid were reviewed. The clinical features, medication and treatment of AAN were analyzed. Results Among 111 patients, there were more females than males (2.58∶1), 101 cases (90.99%) were over 50 years old； the mean age was (63.70±11.67) years old;the average duration of medication was (8.08±6.94) years. The drugs involved were Guanxinsuhe pill and Longdanxiegan pill in 106 cases (95.50%). Serum creatinine increased in 108 cases, urea nitrogen increased in 106 cases and hemoglobin decreased in 103 cases, most of which were hypogravity urine, mild to moderate proteinuria and occult blood. Ultrasonic examination revealed that the kidneys were damaged to varying degrees. Pathological biopsy of kidney showed renal tubular damage. Most patients had an insidious onset and varying degrees of progression, which were not proportional to the age and the duration of taking the medicine. In clinical, the renal function was progressively damaged, most of which were irreversible and with a poor prognosis. Conclusion Patients with renal impairment differed greatly individually, and the renal damage was not paralleled with the medication duration and dose of drugs containing aristolochic acid.AAN progressed rapidly, and the disease still progressed even after stopping taking drugs containing aristolochic acid. Strengthening pharmacovigilance, implementing early diagnosis and effective intervention could help to reduce the occurrence of AAN and attenuate its development. |
| keywords:aristolochic acids|aristolochic acid nephropathy|interstitial nephritis|Guanxinsuhe pill|Longdanxiegan pill|pharmacovigilance |
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