多黏菌素B相关肾毒性的研究进展  

Progress of Polymyxin B Associated Nephrotoxicity

作　　者：王静[1] 吴轩宇 朱怀军 WANG Jing;WU Xuanyu;ZHU Huaijun(Dept.of Pharmacy,Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine,Nanjing 210008,China;Dept.of Pharmacy,Drum Tower Hospital Affiliated to Medical School of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京中医药大学鼓楼临床医学院药学部,南京210008 [2]南京大学医学院附属鼓楼医院药学部,南京210008

出　　处：《中国医院用药评价与分析》2023年第5期637-640,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：江苏省青年医学人才项目(No.QNRC201613)。

摘　　要：多黏菌素B作为治疗多重耐药革兰阴性菌感染的一线药物,其临床应用需求逐渐增加。肾毒性是制约多黏菌素B临床使用的最常见原因。本文从多黏菌素B相关肾毒性的发生率、发生机制、危险因素和降低肾毒性策略4个方面进行综述,以期为其临床合理应用提供参考。多黏菌素B相关肾毒性的发生率为17%~67.7%,血药浓度、给药剂量、年龄和联合用药等是多黏菌素B相关肾毒性的危险因素。多黏菌素衍生物的开发,群体药动学模型的建立,以及代谢组学技术的应用,对降低多黏菌素B相关肾毒性具有潜在的价值。Polymyxin B is a first-line drug for the treatment of multi-drug resistant Gram-negative bacterial infections,and its clinical application demand is gradually increasing.Nephrotoxicity is the most common reason that restricts the clinical use of polymyxin B.This paper reviews the incidence,mechanism,risk factors and strategies to reduce polymyxin B associated nephrotoxicity,in order to provide reference for the clinical application.The incidence of polymyxin B associated nephrotoxicity is from 17%to 67.7%.Blood concentration,dose,age and concomitant drugs are the risk factors of polymyxin B associated nephrotoxicity.The development of polymyxin derivatives,establishment of population pharmacokinetic models,and the application of metabolomics technology have potential value in reducing polymyxin B associated nephrotoxicity.

关 键 词：多黏菌素B 肾毒性 危险因素 降低肾毒性策略 

分 类 号：R969.3[医药卫生—药理学] R978.1[医药卫生—药学]