阿昔洛韦、林可霉素静滴致药物性肾损伤1例

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患者,女,49岁,因“左侧胸背部皮疹5 d,腰腹痛3 d入院”。缘于5 d前无明显诱因出现左侧胸背部皮疹,沿左侧肋间分布,伴瘙痒不适,在附近诊所就诊,诊断为:带状疱疹。予阿昔洛韦注射液1 g ivd、注射用林可霉素1.8 g ivd,当时未出现特殊不适,次日再次输注上述两组液体时出现双侧腰痛、上腹部疼痛、纳差,无恶心、呕吐,无发热、腹泻,无血尿,无尿频、尿急、尿痛,无尿少、水肿,无头昏、头痛,无关节疼痛,无脱发,无光过敏,无口腔溃疡,无骨痛等特殊不适,皮疹较前好转,未重视,第3天输液时上述症状明显加重,遂到当地医院就诊,查血提示:血常规正常,超敏C反应蛋白7.151mg·L~(-1),肝功能大致正常,肾功能:血尿素氮12.06 mmol· Patients, female, 49 years old, due to “left chest and back rash 5 d, abdominal pain 3 d admission ”. Due to 5 d before there was no obvious incentive left chest and back rash, along the left intercostal distribution, with itching and discomfort, at a nearby clinic, diagnosed as: shingles. Acyclovir injection 1 g ivd, injection lincomycin 1.8 g ivd, there was no special discomfort at that time, the next day again infusion of the above two groups of fluids appeared bilateral low back pain, upper abdominal pain, anorexia, no No nausea, vomiting, no fever, diarrhea, no hematuria, no urinary frequency, urgency, dysuria, oliguria, edema, no dizziness, headache, no joint pain, no alopecia, Pain and other special discomfort, the rash better than the previous, did not pay attention, the first 3 days infusion significantly increased the symptoms, then went to the local hospital, check the blood tips: normal blood, high-sensitivity C-reactive protein 7.151mg · L ~ (-1 ), Liver function was normal, renal function: blood urea nitrogen 12.06 mmol ·
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