孕晚期沙库巴曲缬沙坦暴露致新生儿早产合并急性肾衰竭  

Premature birth with neonatal acute kidney failure due to intrauterine exposure of sacubitril valsartan in the third trimester of pregnancy

作　　者：马志会 姬丽刚 赵敏敏 Ma Zhihui;Ji Ligang;ZhaoMinmin(Department of Pharmacy,Jincheng Hospital,Shanxi Province,Jincheng 048006,China)

机构地区：[1]山西省晋城大医院药学部,晋城048006

出　　处：《药物不良反应杂志》2023年第12期759-760,共2页Adverse Drug Reactions Journal

摘　　要：1例早产男婴出生20 h,持续无尿,全身水肿,血清肌酐238μmol/L,肌酐清除率19.45 ml/min,胱抑素C 5.05 mg/L,血清白蛋白28.8 g/L,β_(2)微球蛋白6.52 mg/L,尿微量白蛋白120.2 mg/L,诊断为急性肾衰竭和低蛋白血症。其母亲在婴儿出生前因误诊口服沙库巴曲缬沙坦钠片(50 mg、2次/d)、布美他尼片(1 mg、1次/d)、硫酸氢氯吡格雷片(75 mg、1次/d)和匹伐他汀钙片(2 mg、1次/d)治疗9 d。考虑患儿急性肾衰竭和低蛋白血症与孕晚期沙库巴曲缬沙坦宫内暴露有关。给予静脉补充白蛋白、呋塞米和多巴胺等对症治疗。出生56 h后尿量增加,5 d后尿量恢复正常,8 d后肾功能基本恢复正常。A preterm male infant suffered from continuous anuria for 20-hours,with systemic edema,serum creatinine 238-μmol/L,creatinine clearance rate 19.45-ml/min,cystatin C 5.05-mg/L,serum albumin 28.8-g/L,β_(2) microglobulin 6.52-mg/L,and urinary microalbumin 120.2-mg/L.He was diagnosed with acute kidney failure and hypoalbuminemia.Before his birth,his mother had been treated with sacubitril valsartan sodium tablets(50-mg,twice daily),bumetanide tablets(1-mg,once daily),clopidogrel hydrogen sulfate tablets(75-mg,once daily)and pitavastatin calcium tablets(2-mg,once daily)for 9 days due to misdiagnose.The acute kidney failure and hypoalbuminemia was considered to be associated with in utero exposure to sacubitril valsartan in the third trimester,and symptomatic and supportive treatments such as intravenous albumin supplementation,furosemide,and dopamine were given.After 56-hours of birth,his urine volume obviously increased;after 5 days,his urine volume returned to normal;after 8 days,his renal function basically returned to normal.

关 键 词：妊娠 母亲暴露 沙库巴曲缬沙坦 早产 急性肾衰竭 

分 类 号：R969[医药卫生—药理学]