摘要
目的探讨阿昔洛韦致急性肾功能衰竭(acute renal failure,ARF)的一般规律与特点。方法报道2例阿昔洛韦致ARF的临床表现、实验室检查、治疗及转归,并对相关文献进行复习。结果①2例患者均为青年患者,均在用药24h内起病;②临床表现不一,1例以少尿为主要表现,1例以腰痛为主要表现,2例均伴有恶心纳差;③1例予以停用阿昔洛韦、利尿、碱化尿液及营养支持等对症治疗,4d后肾功能恢复正常,1例通过对症治疗联合3次血液透析治疗,11d后痊愈。结论阿昔洛韦致ARF以肾小管内阻塞为主要发病机制,以非少尿型为主,腰痛是其主要的临床表现,非少尿型ARF经对症治疗多呈良性经过,少尿型ARF多需行血液透析治疗,预防的关键在于规范用药。
Objective To investigate the universal law and characteristic of acyclovir-induced ARF. Methods The clini- cal manifestations ,laboratory testing ,treatment and prognosis of the two cases with acyclovir induced ARF were reported retrospec- tively and the related literatures were reviewed. Results ①Two patients were youth, and ARF developed within 24 hours of acy- clovir administration. ②The clinical manifestations of ARF were varied, 1 patient experienced oliguria, l patient accompanied lumbago and all patients represented nausea and inappetence. ③1 patient recovered completely with discontinuation of acyclovir therapy ,diuresis,alkalization of urine and nutritional support in 4 days, the other patient recovered completely with symptomatic treatment and 3 hemodialysis in 11 days. Conclusion Intratubular crystal obstruction might be the main pathogenesis of acyclov- ir-induced ARF. The main type might be oliguric ARF, lumbago might be its primary symptom. The majority patients of nonoliguric ARF would recover after symptomatic treatment. Most patients of oliguric ARF might need hemodialysis, normative usage of acyclo- vir might be the key to prevent ARF.
出处
《四川医学》
CAS
2013年第9期1310-1312,共3页
Sichuan Medical Journal
