摘要
目的:了解阜阳市人民医院(以下简称"我院")收治的社区获得性药物相关性肾损伤(community-acquired drug-induced kidney injury,CA-DKI)患者的发病原因和治疗方案,为CA-DKI的预防宣教和合理用药提供参考.方法:检索2010—2018年我院收治的CA-DKI患者,回顾性分析CA-DKI与年龄、性别和药物的相关性.结果:共纳入58例CA-DKI患者.CA-DKI可发生于各年龄段人群,≥45岁患者所在比例最高,为72.4%(42/58);女性患者所占比例高于男性患者[56.9%(33/58)vs.43.1%(25/58)];农村患者所占比例明显高于城市患者[75.9%(44/58)vs.24.1%(14/58)];CA-DKI确诊平均需(5.6±2.2)d;<45岁患者的治愈率最高,为43.8%(7/16).导致CA-DKI频次数排序据前3位的药物依次为抗菌药物、非甾体抗炎药和中药;存在保肾药的不合理联合应用(二联用药8例,三联用药16例,四联用药9例).结论:CA-DKI的发病率与地区经济水平呈负相关,治愈率随着年龄增长而降低,诊断、治疗普遍存在延误.改变居民用药、保健习惯,提高医师用药水平,有助于预防和减少CA-DKI的发生.CA-DKI的治疗应遵循指南及循证医学证据,结合患者病情,合理使用保肾药、利尿剂及血液透析.
OBJECTIVE:To investigate the pathogenesis and therapeutic regimens in patients with community-acquired drug-induced kidney injury(CA-DKI)admitted into Fuyang People’s Hospital,so as to provide references for the prevention propaganda and rational drug application of CA-DKI.METHODS:The CA-DKI patients admitted into our hospital from 2010 to 2018 were retrieved and retrospectively analyzed in terms of the correlation between CA-DKI and age,gender and drug.RESULTS:A total of 58 CA-DKI patients were involved.CA-DKI occurred in people of all ages,with the highest proportion of patients≥45 years old,accounted for 72.4%(42/58);the proportion of female patients was higher than that of male[56.9%(33/58)vs.43.1%(25/58)];the proportion of rural patients was significantly higher than that of urban[75.9%(44/58)vs.24.1%(14/58)];The average time of confirmed CA-DKI diagnosis was(5.6±2.2)days;patients aged<45 had the highest cure rate of 43.8%(7/16).The top 3 drugs that induced CA-DKI ranked in the number of cases were respectively antibiotics,non-steroidal anti-inflammatory drugs and traditional Chinese medicines;there were irrational combined application of kidney-protecting drugs(8 cases of two-drug combination,16 cases of three-drug combination and 9 cases of four-drug combination).CONCLUSIONS:The incidence of CA-DKI is negatively correlated with the regional economic level,and the cure rate decreases with age,there are widespread delays in diagnosis and treatment.Changing residents’medications and healthcare habits,improving physicians in rational medication can help to prevent and reduce the occurrence of CA-DKI.The treatment of CA-DKI should follow the guidelines and evidence-based medical evidence,in combination with patient’s condition,rationally use kidney-protecting drugs,diuretics and hemodialysis.
作者
陈伟
王学彬
李小伟
汪晓娟
CHEN Wei;WANG Xuebin;LI Xiaowei;WANG Xiaojuan(Dept.of Pharmacy,Fuyang People’s Hospital,Anhui Fuyang 236000,China;Dept.of Pharmacy,Shanghai Changhai Hospital,Shanghai 200433,China)
出处
《中国医院用药评价与分析》
2019年第7期887-889,894,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
安徽省阜阳市第六批产业创新团队和人才专项资金支持项目(No.中共阜阳市委组织部[2018]69号)
关键词
社区获得性
药物相关性肾损伤
不良反应
保肾药
Community-acquired
Drug-induced kidney injury
Adverse drug reactions
Kidney-protecting drug
