摘要
目的：探讨头孢菌素类抗生素致肾脏不良反应的发生情况。方法查阅了2000-2014年《中国药学文献数据库》中不良反应项下有关头孢菌素类抗生素所致肾脏损害的报道，并进行回顾性分析，逐篇查找并检查相关文献，对其中资料完整的52篇论文中182例病例进行统计分析。结果在因使用头孢类抗生素而发生肾脏损害的158例患者中新生儿和老年人所占比例最高，分别为26．58％、22．78％。另外，经统计学分析发现女性所占比例（55．06％）高于男性（44．94％），但差异无统计学意义（χ2＝0．65，P ＞0．05）。在发生肾脏损害不良反应的158例患者中以使用第三代头孢菌素的患者最多，占59．49％（94／158）；其次是使用第一代头孢菌素的患者占20．25％（32／158）；第二代和第四代头孢菌素使用所占比例最小，分别是13．92％（22／158）、6．33％（10／158）。经统计学分析发现第三代头孢菌素使用比例明显高于第一代、第二和第四代，差异均有统计学意义（χ2＝50．74、70．61、92．32，均 P ＜0．05）。所有的头孢菌素加起来涉及到11种，其中引发肾脏不良反应最多的三种头孢菌素类抗生素分别是头孢他啶、头孢哌酮舒巴坦、头孢曲松，这三种均属于第三代头孢菌素。在158例患者中出现血尿132例，占83．54％；其主要的临床表现为用药过程中出现肉眼可见的血尿，而且少数患者伴有腰部疼痛或腹部疼痛。另外，出现急性肾功能衰竭12例，占7．59％，其中死亡7例。14例患者发生尿潴留，占8．86％；其中8例患者为使用头孢唑啉2～4 d 后出现排尿困难，均为男性，年龄45～75岁，及时停药，经对症治疗后恢复正常。另外，6例患者是在使用头孢替唑和头孢呋辛后出现排尿障碍、腹胀痛，在停药后，症状明显好转。结论头抱菌素类药物对高龄、肾功能不全者应减
Objective To study the occurrence of renal adverse reactions caused by cephalosporin antibiotics.Methods Reviewed 2000 -2014 ＆quot;Chinese medicine literature database＆quot;adverse reaction under the cephalosporin antibiotics kidney damage caused by the reports,and the results were retrospectively analyzed.One by one to find and examine relevant literature,for which complete data of 52 papers in 182 cases of statistical analysis.Results In due to the use of cephalosporins and renal damage in 158 patients in neonates and the elderly accounted for the highest proportion,respectively 26.58% and 22.78%.In addition,the statistical analysis found that the proportion of women（55.06%）was higher than men（44.94%）,but the difference was not statistically significant（χ2 =0.65,P 〉0.05）.In the event of 158 patients with renal damage of adverse reactions to use of the third generation cephalosporins was most,accounted for 59.49% （94 /158 ）;The second was patients with first generation cephalosporin [（20.25%（32 /158）];The second generation box of the fourth generation cephalosporin use accounted for the smallest proportion,13.92%（22 /158）,6.33%（10 /158）.The statistical analysis showed that the third generation cephalosporin use ratio was significantly higher than that of the first generation,the second and the fourth generation,the differences were statistically significant（χ2 =50.74,70.61,92.32,all P 〈0.05）.Add up to of all cephalosporins involves 11,which lead to renal adverse reactions were the most three kinds of cephalosporins antibiotics were ceftazidime,cefoperazone /sulbactam,ceftriaxone,the three belong to the third generation cephalosporins.In 158 patients appeared in 132 cases of hematuria,accounted for 83.54%.The main clinical manifestations for the course of medication appeared visible to the naked eye hematuria,and few patients had pain in the waist or abdominal pain.In addition,there were 12 cases of acute renal failure accounted for 7.59%,including 7 cases of death.14 c
出处
《中国基层医药》
CAS
2015年第22期3398-3400,共3页
Chinese Journal of Primary Medicine and Pharmacy
关键词
头孢菌素类
肾
药物副反应报告系统
Cephalosporins
Kidney
Adverse drug reaction reporting systems
