雷贝拉唑肠溶片致横纹肌溶解和急性肾功能损害1例  

One case of rhabdomyolysis and acute renal damage associated with rabeprazole

作　　者：刘华强[1] 苗莹[1] 初晓[1] 

机构地区：[1]青岛市市立医院药剂科,山东青岛266011

出　　处：《中国药物应用与监测》2017年第3期189-190,共2页Chinese Journal of Drug Application and Monitoring

摘　　要：1例75岁男性患者,既往有糖尿病、冠心病、右束支传导阻滞史,本次因食管炎服用雷贝拉唑肠溶片10 mg,qd,用药2 d后出现大腿肌肉疼痛,伴尿色深,呈茶水色。入院检查,尿常规:尿潜血3+,尿蛋白2+;24 h尿蛋白定量:尿蛋白287.7mg·L^(-1),24 h尿蛋白604.17 mg;肝肾功能:ALT 32 U·L^(-1),AST 25 U·L^(-1),BUN 6.5 mmol·L^(-1),CR 113μmol·L^(-1),CK 302.3 U·L^(-1);MR示左股内侧肌及部分股中间肌轻度肿胀,见弥漫片状高信号。诊断为横纹肌溶解症、药物性肾损害,考虑与药物相关。停用雷贝拉唑后,给予改善微循环、保护肾脏及对症支持治疗。10 d后复查尿常规:尿潜血1+,尿蛋白正常;24 h尿蛋白定量示:尿蛋白145.8 mg·L^(-1),24 h尿蛋白437.4 mg,下肢肌肉不适症状缓解。A 75-year-old male patient with a medical history of diabetes mellitus, coronary heart disease and right bundle branch block was given rabeprazole 10 mg po qd for esophagitis. After 2 days, he developed thigh muscle pain and red-brown urine. Laboratory test values were as follows： urinalysis showed that urine occult blood 3＋, urine protein 2＋; 24-hour urinary protein test displayed that urine protein 287.7 mg·L^-1, 24-hour urinary protein 604.17 mg; liver and kidney function test revealed that ALT 32 U·L^-1, AST 25 U·L^-1, BUN 6.5 mmol·L^-1, CR 113 μmol·L^-1, CK 302.3 U·L^-1; MR exhibited that left medial vastus muscle and partial vastus intermedius were mild swelling with diffuse-patchy hyperintense. Drug induced rhabdomyolysis and acute renal damage were diagnosed. Improving microcirculation, nephroprotection and other symptomatic treatment were given to him. After 10 days, the urin alysis showed that urine occult blood 1＋, urine protein was normal; 24-hour urinary protein test displayed that urine protein 145.8 mg·L^-1, 24-hour urinary protein 437.4 mg; the discomfort symptoms of lower limb muscle were relieved.

关 键 词：雷贝拉唑钠 横纹肌溶解 肾功能损害 药品不良反应 

分 类 号：R975[医药卫生—药品]