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1例75岁男性患者,因头晕、乏力、发热、咳嗽入院。诊为急性粒-单核细胞白血病,给予非格司亭和维A酸治疗。住院15d后,患者慢性阻塞性肺病加重,给予美洛西林、五水头孢唑啉钠和头孢哌酮-舒巴坦治疗之后其症状缓解。又经16d后,实验实检查示:WBC4.38×109/L,N0.71,SCr78μmol/L。患者体温为38.5℃。给予去甲万古霉素800mg静脉滴注,每12h1次,共治疗7d。治疗第5天患者尿量明显减少,为600ml/d。第7天尿量减少至300ml/d,SCr362μmol/L。尿常规:蛋白(+),红细胞(+)。停用去甲万古霉素,给予利尿剂。2d后患者肾功能恢复正常,SCr为120μmol/L。
A 75-year-old male patient was admitted to hospital with cough because of dizziness, weakness, fever. Diagnosis of acute myelomonocytic leukemia, given filgrastim and retinoic acid treatment. 15d after hospitalization, patients with chronic obstructive pulmonary disease exacerbations, given mezlocillin, cefazolin pentafenamate and cefoperazone - sulbactam treatment after the symptoms were relieved. After 16 days, the experimental examination showed: WBC4.38 × 109 / L, N0.71, SCr78μmol / L. The patient’s temperature was 38.5 ° C. To give vancomycin 800mg intravenous infusion, every 12h1 times, a total of 7d. On the fifth day of treatment, the urine output decreased significantly to 600ml / d. On the seventh day, the urine output was reduced to 300ml / d and SCr362μmol / L. Urine: protein (+), red blood cells (+). Stop using norvancomycin and give diuretics. Renal function returned to normal after 2 days, SCr was 120 μmol / L.