112例药物性肾损害的潜伏时间及其影响因素的分析  

Analysis of latency time and its influencing factors in 112 cases of drug-induced kidney injury

作　　者：徐志祥 孙思聪 陈理 刘毅萍 胡婷霞 XU Zhi-xiang;SUN Si-cong;CHEN Li;LIU Yi-ping;HU Ting-xia(Hangzhou Institute for Food and Drug Control,Zhejiang Hangzhou 310022,China;Zhejiang Center for Drug&Cosmetic Evaluation,Zhejiang Hangzhou 310012,China)

机构地区：[1]杭州市食品药品检验研究院,浙江杭州310022 [2]浙江省药品化妆品审评中心,浙江杭州310012

出　　处：《中国医院药学杂志》2020年第17期1864-1868,共5页Chinese Journal of Hospital Pharmacy

摘　　要：目的:探讨药物性肾损害的潜伏时间的分布特征和影响因素,为临床安全合理用药和药物性肾损害的防治提供参考。方法:收集2016年1月1日至2018年12月31日期间杭州地区4家三甲医院收治的疑似药物相关性肾功能损害病例,分析潜伏时间的分布情况,以及药物因素、患者因素、使用因素等对潜伏时间的影响。结果:共收集到符合条件的药物性肾损害药品不良反应报告112例,69.64%的药物性肾损害发生在用药后1周之内。非处方药的药物性肾损害潜伏时间比处方药短。潜伏时间≤14 d的病例eGFR最大降幅比潜伏时间>14 d的高。结论:大部分药物性肾损害发生在用药后1周内,建议用药后一周左右进行随访。14 d内发生的药物性肾损害严重程度较14 d后发生的重,对于早期发现的药物性肾损害患者可能需要给予更多的临床关注。OBJECTIVE To investigate the distribution characteristics and influencing factors of latency time of drug-induced renal injury,and to provide reference for clinical safe and rational drug use and prevention and treatment of drug-induced renal injury.METHODS Suspected cases of drug-related renal impairment admitted to 4 tertiary hospitals in Hangzhou from January 1,2016 to December 31,2018 were collected to analyze the distribution of latency time and the effects of drug factors,patient factors,and use factors on latency time.RESULTS A total of 112 cases of adverse drug reactions were reported,69.64%of which occurred within one week after medication.The latency time of drug-induced renal damage of OTC drugs was shorter than that of prescription.The maximum decrease of eGFR in patients with latency time less than 14 days was higher than that in patients with latency time more than 14 days.CONCLUSION Most of the drug-induced kidney injury occurs within one week after medication.It is suggested that follow-up should be conducted about one week after medication.The severity of drug-induced kidney damage within 14 days is more serious than that after 14 days.Therefore,more clinical attention may be needed for patients with early detection of drug-induced renal injury.

关 键 词：药物性肾损害 药品不良反应 潜伏时间 影响因素 

分 类 号：R97[医药卫生—药品]