环硅酸锆钠治疗肾移植术后早期高钾血症的有效性和安全性评价  

Efficacy and Safety of Sodium Zirconium Cyclosilicate for Early Hyperkalemia After Kidney Transplantation

作　　者：佟雪瑞 陈攀[1] 林晓彬 邓雪婷 闫佳佳[1] TONG Xuerui;CHEN Pan;LIN Xiaobin;DENG Xueting;YAN Jiajia(Department of Pharmacy,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong 510080,China;Department of Pharmacy,the Third Affiliated Hospital of Sun Yat-sen University,Zhaoqing Hospital,Zhaoqing,Guangdong 526070,China)

机构地区：[1]中山大学附属第一医院药学部,广东广州510080 [2]中山大学附属第三医院肇庆医院药剂科,广东肇庆526070

出　　处：《今日药学》2024年第4期288-292,共5页Pharmacy Today

基　　金：广东省医院药学研究基金(2022A06,2023A05)。

摘　　要：目的评价环硅酸锆钠在肾移植术后早期高钾血症患者中的有效性及安全性。方法回顾性统计2020年9月~2022年1月某院肾移植科使用环硅酸锆钠治疗肾移植术后早期高钾血症的病例,分为总体组、单用环硅酸锆钠组及环硅酸锆钠联合胰岛素组进行分析,比较各组患者人口学特征与临床基本信息,评价治疗前后血钾水平变化、降钾幅度、血钾达标率等差异。结果总体33例患者用药前血钾平均水平为(6.05±0.48)mmol·L^(-1),用药后24、48、72 h平均降钾幅度分别为1.10、1.03、1.15 mmol·L^(-1),达标率分别为78.10%、63.30%、85.00%。单用环硅酸锆钠组用药前血钾平均水平为(5.74±0.41)mmol·L^(-1),用药后24、48、72 h平均降钾幅度分别为0.91、0.90、1.03 mmol·L^(-1),达标率分别为92.30%、80.00%、100.00%。联用胰岛素组的用药前血钾水平为(6.25±0.41)mmol·L^(-1),用药后24、48、72 h平均降钾幅度分别为1.24、1.10、1.24 mmol·L^(-1),达标率分别为68.40%、55.00%、72.70%。安全性方面,仅有5例患者出现环硅酸锆钠相关的低钾血症,1例患者出现便秘。结论环硅酸锆钠可以短期快速降低肾移植术后患者的高血钾水平,但需警惕低钾血症。OBJECTIVE To evaluate the efficacy and safety of sodium zirconium cyclosilicate for early hyperkalemia after kidney transplantation.METHODS The cases of early hyperkalemia after renal transplantation treated with sodium zirconium silicate from September 2020 to January 2022 were retrospectively analyzed.They were divided into total group,single sodium zirconium silicate group and sodium zirconium silicate combined with insulin group.The demographic characteristics and basic clinical information of each group were compared,and the changes of serum potassium level,the range of potassium reduction and the standard-reaching rate before and after treatment were evaluated.RESULTS Before medication,the average serum potassium level of the 33 patients in total group was(6.05±0.48)mmol·L^(-1),and the average decreases of potassium at 24,48,72 h after medication were 1.10,1.03,1.15 mmol·L^(-1),with the standard-reaching rate of 78.10%,63.30%and 85.00%,respectively.Before medication,the average blood potassium level of sodium zirconate cyclosilicate group was(5.74±0.41)mmol·L^(-1),and the average potassium reduction range was 0.91,0.90,1.03 mmol·L^(-1)after treatment at 24,48,72 h,and the standard-reaching rate was 92.30%,80.00%and 100.00%,respectively.In the combined insulin group,the serum potassium level before medication was(6.25±0.41)mmol·L^(-1),and the average decreases of potassium at 24,48,72 h after medication was 1.24,1.10,1.24 mmol.L^(-1),and the standard-reaching rate was 68.40%,55.00%and 72.70%,respectively.In terms of safety,only 5 patients developed hypokalemia related to sodium zirconium cyclosilicate,and 1 patient developed constipation.CONCLUSION Sodium zirconium cyclosilicate can quickly reduce hyperkalemia in kidney transplant patients,but should be aware of hypokalemia.

关 键 词：环硅酸锆钠 高钾血症 肾移植 有效性 安全性 

分 类 号：R969[医药卫生—药理学]