克林霉素致腹痛、血尿及急性肾衰竭  

Clindamycin-induced abdominal pain,hematuria and acute renal failure

作　　者：石李金 高琴[1] 许敏[1] 王国庆[1] 黄仑峰 

机构地区：[1]黄梅县人民医院呼吸内科,湖北黄梅435500

出　　处：《药物不良反应杂志》2011年第1期46-46,共1页Adverse Drug Reactions Journal

摘　　要：1例43岁女性患者因支气管扩张合并感染,给予头孢替唑钠2.0 g加入0.9%氯化钠注射液250 ml静脉滴注。5 h后给予克林霉素1.2 g加入10%葡萄糖注射液500 ml静脉滴注。静滴约20 min时,患者出现腹痛、频繁呕吐、肉眼血尿。立即停用克林霉素,分别肌内注射双氯酚酸钠50 mg、西咪替丁200 mg后患者腹痛缓解。给予克林霉素3 h后至次日晨患者无尿,并出现全身水肿。肾功能检查:尿素氮17.6 mmol/L,肌酐544μmol/L。诊断为克林霉素所致急性肾衰竭。入院第3、6天行血液透析,患者尿量逐渐恢复正常,尿素氮4.3 mmol/L、肌酐65μmol/L。滴注头孢替唑钠2.0 g/d抗感染后,患者咳嗽减轻,脓痰消失,第7天出院。A 43-year-old woman with bronchiectasis complicated by infection received an IV infusion of ceftezole sodium 2.0 g dissolved in 0.9% sodium chloride 250 ml,followed by an IV infusion of clindamycin 1.2 g dissolved in 10% glucose 500 ml 5 hours later.About 20 minutes after the infusion started,the patient experienced abdominal pain,repeated vomiting,and gross hematuria.Clindamycin was discontinued immediately and she was given IM diclofenac sodium 50 mg and IM cimetidine 200 mg.Later,her abdominal pain alleviated.She failed to urinate 3 hours after the administration of clindamycin until the next morning,and then generalized edema occurred.Renal function tests showed the following values： blood urea nitrogen 17.6 mmol/L,serum creatinine 544 μmol/L.She was diagnosed with clindamycin-induced acute renal failure.On days 3 and 6 after admission she received hemodialysis,and then her urine output gradually returned to normal range.Her blood urea nitrogen and serum creatinine levels were 4.3 mmol/L and 65 μmol/L,respectively.After administration of an infusion of ceftezole sodium 2.0 g/d for treatment infection,the patient＇s symptom of cough was relieved and purulent sputum disappeared.On day 7,she was discharged.

关 键 词：克林霉素 腹痛 肾衰竭 

分 类 号：R595.3[医药卫生—内科学]