导致121例老年患者急性肾损伤的相关药物分析  

Analysis of Related Drugs Leading to 121 Cases of Senile Acute Kidney Injury

作　　者：刘将 郑旭敏 涂天琪 高红梅[2] 邹古明[2] 卓莉[2] 李文歌 LIU Jiang;ZHENG Xumin;TU Tianqi;GAO Hongmei;ZOU Guming;ZHUO Li;LI Wenge(China-Japan Friendship Clinical Medicine College,Peking University,Beijing 100029,China;Dept.of Nephrology,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]北京大学医学部中日友好临床医学院,北京100029 [2]中日友好医院肾病科,北京100029

出　　处：《中国医院用药评价与分析》2021年第5期603-607,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：北京市科技计划(No.D171100002817003)。

摘　　要：目的:了解老年急性肾损伤(acute kidney injury,AKI)患者发生AKI近3个月内口服的药物,为临床预防老年AKI提供依据。方法:回顾性分析2001年1月至2020年6月于中日友好医院住院并进行肾穿刺活检确诊为AKI的老年患者的临床资料、基础病史及近3个月内口服药物情况。结果:符合入组标准的老年AKI患者共121例,其中男性患者65例(占53.7%),女性患者56例(占46.3%);中位年龄为65(62,69)岁;肾穿刺活检病理结果:急性间质性肾炎37例(占30.6%),亚急性间质性肾炎84例(占69.4%);入院时中位血肌酐水平为216.0(156.5,323.4)μmol/L。在排除了服用非甾体解热镇痛药、抗病毒药和抗菌药物等常见肾毒性药物后,患者近3个月内常用的口服药分为抗高血压药、抗糖尿病药、调节血脂药、利尿剂、中草药、抗凝血药或抗血小板药、降尿酸药、胃肠道用药及其他(如甲氨蝶呤、依帕司他等)等9类;其中,103例(占85.1%)服用抗高血压药,44例(占36.4%)服用抗糖尿病药,25例(占20.7%)服用调节血脂药,25例(占20.7%)服用利尿剂,44例(占36.4%)服用中药,20例(占16.5%)服用抗凝血药或抗血小板药,9例(占7.4%)服用降尿酸药,3例(占2.5%)服用胃肠道用药,34例(占28.1%)服用其他类药物;21例(占17.4%)服用1类药物,49例(占40.5%)同时服用2类药物,23例(占19.0%)同时服用3类药物,19例(占15.7%)同时服用4类药物,7例(占5.8%)同时服用5类药物,2例(占1.7%)同时服用6类药物,中位用药种类数为2(2,3)类。结论:老年人是药物相关AKI的高危人群,虽然服用的是常用药物,但多种常见药物联合应用有发生AKI的风险,因此用药期间应注意监测患者肾功能的变化。OBJECTIVE:To investigate the drugs taken orally within 3 months in the elderly with acute kidney injury(AKI),so as to provide evidence for clinical prevention of AKI in the elderly.METHODS:The clinical data,basic medical history and oral medication in recent 3 months of the elderly diagnosed with AKI who underwent renal needle biopsy in China-Japan Friendship Hospital from Jan.2001 to Jun.2020 were retrospectively analyzed.RESULTS:A total of 121 elderly patients with AKI met the inclusion criteria,including 65 male patients(53.7%)and 56 female patients(46.3%).The median age was 65(62,69)years old.The pathological results of renal needle biopsy were acute interstitial nephritis in 37 cases(30.6%)and subacute interstitial nephritis in 84 cases(69.4%).The median serum creatinine level was 216.0(156.5,323.4)μmol/L at admission.After excluding the use of common nephrotoxic drugs such as non-steroid anti-inflammatory,antiviral drugs and antibiotics,the commonly used oral drugs were divided into antihypertensive drugs,hypoglycemic drugs,lipid-lowering drugs,diuretics,Chinese herbal medicines,anticoagulants or platelet aggregation inhibitors,uric acid-lowering drugs,gastrointestinal drugs and others(methotrexate and epalrestat).There were 103 cases(85.1%)treated with antihypertensive drugs,44 cases(36.4%)with hypoglycemic drugs,25 cases(20.7%)with lipid-lowering drugs,25 cases(20.7%)with diuretics,44 cases(36.4%)with traditional Chinese medicine,20 cases(16.5%)with anticoagulant or platelet aggregation inhibitors,9 cases(7.4%)with uric acid-lowering drugs and 3 cases(2.5%)with gastrointestinal drugs,and 34 cases(28.1%)with other drugs.According to the number of types of drugs taken at the same time,there were 21 cases(17.4%)took one type of drug,49 cases(40.5%)took two types of drugs,23 cases(19.0%)took three types of drugs,19 cases(15.7%)took four types of drugs,7 cases(5.8%)took five types of drugs and 2 cases(1.7%)took six types of drugs,the median of medication was 2(2,3).CONCLUSIONS:The elderly are at high risk of

关 键 词：老年人 急性肾损伤 肾脏病理 多药联合应用 基础疾病 

分 类 号：R97[医药卫生—药品]