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利福平(RFP)作为治疗结核病一线药物已广泛应用于临床.其副作用有肝细胞中毒性黄疸、免疫性血小板减少、溶血、哮喘样发作和急性肾功能不全等。自1971年首次报道利福平引起急性肾功能不全至今,国内外已报道百余例.该并发症临床较少见,且系最严重并发症之一.发病机理一、免疫机制(一)Ⅰ型变态反应:部分病人服 RFP 后,即刻出现皮疹、发热等症状,嗜酸粒细胞增多,可高达白细胞的40%.病人血中 IgE 增高,血浆组胺升高;肾活检有粗大 IgE 颗粒沉积在肾小管.(二)Ⅲ型变态反应:系最常引用的发病机
Rifampicin (RFP) has been widely used as a first-line drug in the treatment of tuberculosis and its side effects include hepatotoxicity jaundice, immune thrombocytopenia, hemolysis, asthma-like seizures and acute renal insufficiency. Since the first report of rifampin-induced acute renal insufficiency in 1971, more than 100 cases have been reported at home and abroad. The complication is relatively rare and one of the most serious complication. Pathogenesis, immune mechanism (Ⅰ) Ⅰ Type allergy: some patients taking RFP immediately after rash, fever and other symptoms, eosinophilia, up to 40% of leukocytes in patients with elevated serum IgE, plasma histamine increased; renal biopsy coarse IgE particles deposited In the tubules. (B) Type Ⅲ allergy: the most commonly cited pathogenesis