环孢素A致重度慢性肾小管-间质损伤1例  

A case of severe chronic renal tubular-interstitial injury induced by Cyclosporin A

作　　者：吴慧仪[1] 潘裕华[2] 劳海燕[2] WU Huiyi1, PAN Yuhua2, LAO Haiyan2(1.Department of Pharmacy, Nanfang Hospital of Southern Medical University, Guangdong 510515, China; 2.Department of Pharmacy, Guangdong General Hospital, Guangdong Province, China Province, Guangzhou 510080,Chin)

机构地区：[1]南方医科大学南方医院药剂科,广东广州510515 [2]广东省人民医院药学部,广东广州510080

出　　处：《中国医药导报》2018年第15期154-157,共4页China Medical Herald

摘　　要：1例膜性肾病患者使用环孢素A联合小剂量糖皮质激素治疗后出现血肌酐进行性升高、血压升高,重复肾穿刺活检术提示病理改变为Ⅲ期膜性肾病伴重度慢性肾小管-间质损伤。结合患者病史、临床表现、实验室及病理检查,排除其他因素,考虑主要为环孢素A所致不可逆重度慢性肾小管-间质损伤。通过对病例的分析总结提示,环孢素A慢性肾毒性副作用明显,虽然其肾毒性呈剂量、浓度依赖性,但其血药浓度在正常治疗范围时,仍有可能发生肾毒性。因此,临床医生在用药过程中应高度重视,充分掌握环孢素A相关知识,对其引起的肾毒性提前预防、早期发现、及时干预,降低其发生风险和危害。One patient with membranous nephropathy used Cyclosporin A and low dose of glucocorticoid for treatment,after continuous medication, the patient′s serum creatinine and blood pressure progressively increased. The pathological changes after repeated kidney biopsy suggested the phase Ⅲ membranous nephropathy associated with severe chronic renal tubular-interstitial injury. In combination with medical history, clinical manifestations, laboratory and pathological examination, excluding other factors, Cyclosporin A is considered to be the main contributor to irreversible chronic renal tubule-interstitial injury. By analyzing and summarizing of the case, chronic renal toxicity is the obvious side effect of Cyclosporin A. Although the renal toxicity depends on the dose or concentration of Cyclosporin A, it can still happen when the plasma concentration in the normal range of treatment. Therefore, clinicians should attach great importance to the use of Cyclosporin A, fully grasp its relevant knowledge, prevent early and interfere timely to Cyclosporin A related nephrotoxicity, reducing the risk and harm.

关 键 词：环孢素A 药物肾毒性 慢性肾损害 

分 类 号：R227.526[医药卫生—中医基础理论]