钙调蛋白抑制剂致肾损伤45例文献分析  

Acute kidney injury caused by calcineurin inhibitor and literature review

作　　者：郭慧蕾[1] 徐进[1] 张永[1] 许静[1] 

机构地区：[1]南京医科大学附属南京儿童医院,南京210008

出　　处：《中南药学》2015年第10期1100-1104,共5页Central South Pharmacy

摘　　要：目的分析钙调蛋白抑制剂致肾损伤的发生规律和临床特点,为临床合理用药提供参考。方法检索1979~2014年间国内外期刊报道的钙调蛋白抑制剂致肾损伤的个案,进行统计分析。结果共检索到个案45例,其中环孢素所致肾损伤31例,他克莫司14例。中老年男性且有基础肾脏疾病患者为易感人群。100%有急性肾损伤（AKI）表现,91.1%痊愈,62.3%恢复时间小于28 d,其血药浓度与个体基因型差异、联合用药均有关联。结论钙调蛋白抑制剂的长期应用应遵照指南,尤其对于易感人群及个体差异明显者,应密切监测肾功能和血药浓度,必要时进行重复肾活检和基因检测。Objective To analyze the occurrence and clinical characteristics of calcineurin inhibitor （CNI）-induced nephrotoxicity, and to promote the rational use of CNI. Methods We retrieved and analyzed literature of CNI- induced kidney injury reported at home and abroad from 1979 to 2014. Results Totally 45 case were collected, 31 of which were caused by ciclosporin, and 14 by tacrolimus. Middle-aged men with primary kidney diseases were the vulnerable groups. All patients （45 cases） had acute kidney injury, 41 （91. 1%） recovered, 28 （62.3%） recoverd in less than 28 days, and the drug concentration was associated with individual genotype differences and drug com- bination. Conclusion Long-term application of CNI should follow the guidelines, especially in the vulnerable groups and specific individuals. We should monitor the kidney function and drug concentration, and repeat renal biopsy and genetic testing when necessary.

关 键 词：钙调蛋白抑制剂 肾毒性 文献分析 

分 类 号：R969-3[医药卫生—药理学]