美罗培南致住院患者急性肾损伤的药物不良反应分析  

Analysis of adverse drug reactions induced by meropenem in inpatients with acute kidney injury

作　　者：杜朝阳[1,2] 谢铮铮[1] 赵莹[1,2] 陈张勇 李光耀 孙路路 

机构地区：[1]首都医科大学附属北京世纪坛医院药剂科,北京100038 [2]北京大学药学院药事管理与临床药学系,北京100191 [3]首都医科大学化学生物学与药学院临床药学系,北京100069

出　　处：《中国临床药理学杂志》2017年第23期2431-2433,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的研究美罗培南致我院住院患者急性肾损伤的药物不良反应发生情况和相关因素。方法回顾性收集2015年我院住院期间使用美罗培南的400例患者的病历资料,分析用药前后血清肌酸酐水平变化和联合用药情况。通过筛选符合急性肾损伤诊断的病例,并用Naranjo评分法进行美罗培南与急性肾损伤的关联性评价。结果最终共收集到375例患者,其中急性肾损伤组8例(肾损害发生率为2.13%),无急性肾损伤组367例。急性肾损伤组男性6例,年龄(72.83±9.79)岁,女性2例,年龄(84.50±12.02)岁;无急性肾损伤组男性194例,年龄(80.24±11.24)岁,女性173例,年龄(77.84±12.87)岁,2组患者的性别分布和年龄差异均无统计学意义(均P>0.05)。应用美罗培南前,急性肾损伤组和无肾损伤组的血清肌酸酐浓度分别为(104.25±53.22)和(100.23±14.54)μmol·L^(-1),差异无统计学意义(P>0.05)。应用美罗培南2~11(5.75±2.86)d后,急性肾损伤组血清肌酸酐升高为(304.38±160.78)μmol·L^(-1),与用药前比较,差异有统计学意义(P<0.05)。8例急性肾损伤患者中,6例同时联用肾毒性药物,3例出现急性肾损伤后立即改用其他抗菌药。结论美罗培南可导致患者发生急性肾损伤,患者合并易引起肾损害的基础疾病和药物相互作用等可能与急性肾损伤的发生相关。Objective To explore the occurrence and related factors of acute kidney injury induced by meropenem in inpatients. Methods The clinical data of the 400 patients who were hospitalized in Beijing Shijitan Hospital in 2015 and received meropenem treatments were collected randomly and analyzed retrospectively. The main analytic indicators included the change of serum creatinine before and after meropenem treatment and the drug combinations. Through screening the cases conformed to the diagnosis of acute renal injury,and using the Naranjo algorithm to evaluate the correlation of meropenem and acute kidney injury to determine the drug-induced acute kidney injury patients（ hereinafter referred to as the patients with acute kidney injury）. Results A total of 375 patients were enrolled in this study. There were 8（ 2. 13%） patients in the acute kidney injury group and 367 patients in the no acute kidney injury group.It comprised 6 men with age of（ 72. 83 ± 9. 79） years,and 2 women with age of（ 84. 50 ± 12. 02） years in the acute kidney injury group; while itcomprised 194 men with age of（ 80. 24 ± 11. 24） years,and 173 women with age of（ 77. 84 ± 12. 87） years in the no acute kidney injury group. There were no statistical significance in gender and age distribution in patients between the two groups（ all P〈0. 05）. The serum creatinine levels before meropenem treatment were（ 104. 25 ± 53. 22）μmol·L-1 in patients in the acute kidney injury group and（ 100. 23 ± 14. 54） μmol·L-1 in patients in the no acute kidney injury group. The difference was no statistical significance between the 2 groups（ P〈0. 05）. The serum creatinine levels increased to（ 304. 38 ± 160. 78） μmol · L-1 after（ 5. 75 ± 2. 86） days receiving meropenem treatments in patients in the acute kidney injury group. The difference before and after treatment was statistically significant（ P〈0. 05）. In the 8 patients with acute kidney injury,6 of them combined with nephrotoxic drug at the same time

关 键 词：美罗培南 急性肾损害 药物不良反应 住院患者 

分 类 号：R978.1[医药卫生—药品]