1例乙肝肝硬化患者长期服用阿德福韦酯致肾功能损伤的病例分析与药学监护  

Case analysis and pharmaceutical monitoring of renal impairment caused by long-term use of Adefovir dipivoxil in one case with hepatitis B cirrhosis

作　　者：孙烨 顾黎佳 高红锐 SUN Ye;GU Lijia;GAO Hongrui(Shanghai Civil Affairs First Mental Health Center,Department of Pharmacy,Shanghai 201100,China;Shanghai Civil Affairs First Mental Health Center,Science and Education Department,Shanghai 201100,China)

机构地区：[1]上海市民政第一精神卫生中心药剂科,上海201100 [2]上海市民政第一精神卫生中心科教科,上海201100

出　　处：《中国民康医学》2023年第20期146-149,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨阿德福韦酯致肾功能损伤的诊治方法及药学监护作用。方法:回顾性分析1例乙肝肝硬化患者长期服用阿德福韦酯致肾功能损伤的诊疗过程,临床药师借助药学知识协助医师分析患者病情,查阅相关权威文献证据,及早识别患者肾损伤病因,并给予患者用药指导。结果:该例患者为阿德福韦酯引起的近端肾小管酸中毒并发Fanconi综合征,及时停药更换为安全性较好的恩替卡韦,并予以对症治疗后,患者肾功能指标好转。结论:针对长期服用阿德福韦酯的患者应定期监测肾功能指标,临床药师参与用药过程监测和用药指导对保障患者用药安全有重要意义。Objective:To explore diagnosis and treatment of renal impairment induced by Adefovir dipivoxil and effects of pharmaceutical monitoring.Methods:A retrospective analysis of the diagnosis and treatment process of one case with hepatitis B cirrhosis with renal impairment caused by long-term use of Adefovir dipivoxil was performed.With the help of pharmaceutical knowledge,the clinical pharmacists assisted the physicians to analyze the patient’s conditions.Further,through consulting relevant authoritative literature evidence,it aimed to identify the cause of renal impairment of the patient as early as possible,and then give the according medication guidance.Results:This patient was diagnosed with Fanconi syndrome caused by proximal tubular acidosis induced by Adefovir dipivoxil.Timely withdrawal was given,and it was replaced by Entecavir with better safety.After symptomatic treatment,the renal function indexes of the patient improved.Conclusions:Renal function indexes should be monitored regularly for the patients with long-term use of Adefovir dipivoxil.Clinical pharmacists’participation in the medication process monitoring and the medication guidance is of great significance to ensure the safety of the patients’medication.

关 键 词：阿德福韦酯 慢性乙型肝炎 肝硬化 肾损伤 FANCONI综合征 药学监护 病例报告 

分 类 号：R969[医药卫生—药理学]