他克莫司致儿童急性胰腺炎2例  

Two Cases of Acute Pancreatitis in Children Induced by Tacrolimus

作　　者：陈楷柠 杜悦[1] Chen Kaining;Du Yue(Shengjing Hospital of China Medical University,Shenyang 110000,China)

机构地区：[1]中国医科大学附属盛京医院,沈阳110000

出　　处：《儿科药学杂志》2023年第3期45-48,共4页Journal of Pediatric Pharmacy

摘　　要：目的:探讨他克莫司治疗儿童肾脏疾病导致急性胰腺炎的临床表现和病因,分析他克莫司与急性胰腺炎的相关性,为临床制定合理的诊疗方案提供参考。方法:回顾性分析中国医科大学附属盛京医院小儿肾脏与风湿免疫科2018-2020年收治的2例应用他克莫司后出现急性胰腺炎患儿的临床资料。结果:2例患儿在他克莫司应用过程中出现急性胰腺炎,包括典型上腹部疼痛、血淀粉酶和脂肪酶升高3倍以上,影像学符合胰腺炎改变。经停用他克莫司、禁食禁水、抑制胃酸分泌等对症支持治疗,症状、实验室检查、影像学均恢复正常。结论:对于肾脏风湿免疫系统疾病患儿,应用他克莫司应警惕急性胰腺炎,密切关注患儿症状与体征,及时完善血淀粉酶、脂肪酶、尿淀粉酶等实验室检查及胰腺影像学检查,早期诊断、治疗,防止病情进展导致全身性损害。Objective:To analyze the clinical manifestations and etiology of acute pancreatitis in children with nephrosis after tacrolimus treatment,and to explore the correlation between tacrolimus and acute pancreatitis,so as to provide a reference for making reasonable diagnosis and treatment regimens in clinical practice.Methods:The medical records of 2 children with acute pancreatitis after tacrolimus treatment in the Pediatric Nephrology and Rheumatic Immunology Department of Shengjing Hospital of China Medical University from 2018 to 2020 were retrospectively analyzed.Results:Acute pancreatitis occurred in 2 children during tacrolimus treatment,including digestive system symptoms and signs,such as typical upper abdominal pain,blood amylase and lipase increased by more than 3 times,and imaging consistent with the change of pancreatitis.After discontinuation of tacrolimus,fasting for solids and liquids,inhibition of gastric acid secretion and other supportive treatments,the clinical symptoms,laboratory examination,and the imaging returned to normal.Conclusion:For children with renal rheumatic immune system diseases,we should be alert to the occurrence of acute pancreatitis when using tacrolimus,pay close attention to the symptoms and signs of children,timely improve the laboratory examination of blood amylase,lipase,urine amylase and pancreatic imaging examination,and realize early diagnosis and treatment,thus preventing systemic damage caused by disease progression.

关 键 词：他克莫司 药物性胰腺炎 胰腺损伤 

分 类 号：R725.7[医药卫生—儿科]