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目的:探讨阿昔洛韦导致的急性肾衰竭(ARF)的临床特征,指导临床安全用药。方法:对我院从1997年1月～2008年12月收治的阿昔洛韦致ARF的临床资料进行回顾性分析。结果:患者发病的平均年龄为(42.4±17.7)岁,在用药5d内起病;临床表现以腰痛、腰酸,恶心、呕吐,蛋白尿,镜下血尿为主,其中非少尿型16例(80%),少尿型4例(20%),平均血肌酐水平(Scr)(402.9±122.3)μmol·L~(-1);患者均停用阿昔洛韦,给予水化、碱化尿液等对症处理,其中4例少尿型ARF患者行血液透析治疗;肾功能于3～15d内完全缓解。其发生主要与单次用药剂量过大、静滴速度过快(滴注时间不足1h)、输液后未补充足够的水份有关。结论:应注意阿昔洛韦不良反应中的急性肾衰竭,加强监测,确保用药安全。
Objective: To investigate the clinical characteristics of acyclovir-induced acute renal failure (ARF) and to guide clinical safety medication. Methods: The clinical data of acyclovir-induced ARF in our hospital from January 1997 to December 2008 were analyzed retrospectively. Results: The average age of onset was (42.4 ± 17.7) years old, onset within 5 days. The clinical manifestations were low back pain, backache, nausea, vomiting, proteinuria and microscopic hematuria. Among them, 80%), oliguric type in 4 cases (20%) and mean serum creatinine level (402.9 ± 122.3) μmol·L -1. All the patients were discontinued acyclovir, given hydration and alkalinization Urine and other symptomatic treatment, of which 4 patients with oliguric ARF hemodialysis treatment; renal function within 3 ~ 15d completely remission. The main and single dose is too large, intravenous infusion rate too fast (infusion time less than 1h), did not add enough water after infusion related. Conclusions: Acute renal failure in acyclovir adverse reactions should be noted and monitoring should be strengthened to ensure drug safety.