药物、毒物和食物相关急性肾衰竭的临床研究  

A Clinical Research of Food,Drug and Poison-related Acute Renal Failure

作　　者：黄莉[1] 徐瑾[2] 廖蕴华[1] 

机构地区：[1]广西医科大学第一附属医院,南宁市530021 [2]广西医科大学第三附属医院暨南宁市第二人民医院,南宁市530031

出　　处：《广西医学》2011年第1期28-32,共5页Guangxi Medical Journal

基　　金：广西医药卫生科学研究基金(桂卫科Z2007087)

摘　　要：目的了解药物、毒物和食物相关急性肾衰竭(ARF)的病因构成、预后,为药物、毒物和食物相关ARF的早期防治提供理论依据。方法对药物、毒物和食物相关ARF患者进行回顾性分析,并与其他病因ARF进行比较,总结其病因及其转归的特点。结果药物、毒物和食物相关ARF患者119例,占同期ARF的19.5%;患者男女比例为2.0∶1.0,年龄(41.0±18.9)岁。药物相关ARF的病因排在首位为抗生素32例(33.7%),其次为甘露醇19例(20.0%)、中草药17例(17.9%)、非甾体类抗炎药(NSAIDs)6例(6.3%)、化疗药5例(5.3%);毒物相关ARF首位病因为农药中毒6例(25.0%),其次为生鱼胆5例(20.8%)、蜂毒4例(16.7%);食物相关ARF的病因为杨桃共2例。与非药物、毒物和食物相关ARF相比,药物、毒物和食物相关ARF病死率低(7.6%和16.7%)。多元logistic回归分析提示合并MODS是药物、毒物和食物相关ARF患者肾功能预后不良的危险因素。结论药物、毒物和食物相关ARF并不少见,合并MODS患者预后较差,病死率高,临床医师应积极治疗。Objective To investigate the etiology, prognosis, risk factors of death among acute renal failure （ARF） patients from drug,food and poison,providing a theory basis for the prevention and treatment of ARF induced by drug,food and poison. Methods The clinical data of ARF patients induced by drug,food and poison were analyzed retrospectively, compared the those data with other etiology, and summarized features, clinical characteristic and prognosis of ARF. Results 119 ARF patients induced by drug,food and poison, which accounted for 19.48% of total amount of ARF admitted during the same time. The sex ratio of male to ferule was 2.0 ： 1.0, the age was （40.96 ＋ 18.87 ） years. The main causes of ARF from drug were antibiotics （33. 68% ）, mannitol （20. 00% ）, traditional Chinese medicine （ 17.89% ）, non-steroidal anti-inflammatory drugs （NSA/Ds） （6. 32% ）, chemotherapeutics （5.26%）. The main causes of ARF induced by poison were organophosphorus compounds （25.00%）,fish gall bladder poisoning （20. 83% ）, bee venom （ 16.67% ）. The mortality of ARF induced by drug,food and poison lower than that of other etiology（7.56% vs 16.7% ）. Multiple logistic regression analysis showed MODS was the risk factor of irreversible renal failure in ARF induced by drug, food and poison. Conclusion ARF induced by drug, food and toxic is not uncommon in ARF, those with MODS may be poor prognosis and high fatality ratio, and these vatients should be treated actively.

关 键 词：肾衰竭 药物 毒物 食物 病死率 

分 类 号：R692.5[医药卫生—泌尿科学]