安罗替尼致急性肾衰竭并肝功能异常和血小板减少症  

Anlotinib-induced acute renal failure,liver dysfunction,and thrombocytopenia

作　　者：王兴东[1] 姚灿 李波霞[1] 王荣珍[2] 魏玉辉[1] Wang Xingdong;Yao Can;Li Boxia;Wang Rongzhen;Wei Yuhui(Department of Pharmacy,the First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Nephrology,the First Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一医院药剂科,兰州730000 [2]兰州大学第一医院肾病科,兰州730000

出　　处：《药物不良反应杂志》2024年第8期499-501,共3页Adverse Drug Reactions Journal

基　　金：甘肃省自然科学基金(21JR7RA380);兰州大学第一医院青年基金(ldyyyn2020-77)。

摘　　要：1例59岁女性肺癌患者应用安罗替尼(标准方案)2个周期后出现胸闷、气短、乏力、少尿,实验室检查示血肌酐995.5μmol/L,尿素氮18.9 mmol/L,血尿酸637μmol/L,24 h尿量400 ml,血钾3.63 mmol/L,丙氨酸转氨酶(ALT)518 U/L,天冬氨酸转氨酶(AST)32 U/L,总胆红素38.8μmol/L,血小板计数45×10^(9)/L。诊断为急性肾衰竭、肝功能异常、血小板减少症。辅助检查结果排除基础疾病进展所致可能性。患者临床症状与口服安罗替尼存在时间相关性。停用该药并给予血液透析、保肝、利尿等对症治疗。14 d后,患者胸闷、气短、乏力明显缓解;实验室检查示血肌酐480.3μmol/L,尿素氮16.2 mmol/L,血尿酸414μmol/L,24 h尿量1700 ml,血钾3.18 mmol/L,ALT 45 U/L,AST 31 U/L,总胆红素37.4μmol/L,血小板计数81×10^(9)/L。A 59-year-old female patient with lung cancer developed chest tightness,shortness of breath,fatigue,and oliguria after 2 cycles of anlotinib standard regimen.Laboratory tests showed serum creatinine 995.5?μmol/L,urea nitrogen 18.9 mmol/L,blood uric acid 637μmol/L,24 hour urine output 400 ml,blood potassium 3.63 mmol/L,alanine aminotransferase(ALT)957 U/L,aspartate aminotransferase(AST)32 U/L,total bilirubin 38.8μmol/L,and platelet count 49×109/L.Acute renal failure,liver dysfunction,and thrombocytopenia was diagnosed.The auxiliary examination results excluded the possible progression of underlying diseases.The clinical manifestations of the patient were time?dependent with oral administration of anlotinib.Anlotinib was discontinued and symptomatic treatments such as hemodialysis,liver protection,and diuresis were given.After 14 days,chest tightness,shortness of breath,and fatigue were significantly relieved.Laboratory tests showed serum creatinine 480.3μmol/L,urea nitrogen 16.2 mmol/L,blood uric acid 414μmol/L,24 hour urine output 1700 ml,blood potassium 3.18 mmol/L,ALT 45 U/L,AST 31 U/L,total bilirubin 37.4μmol/L,and platelet count 81×10^(9)/L.

关 键 词：急性肾衰竭 血小板减少症 肝功能异常 安罗替尼 酪氨酸激酶抑制剂 抗肿瘤药物 

分 类 号：R979.1[医药卫生—药品]