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1.济南医院药剂科，山东济南　250001；2.济南医院感染管理科，山东济南　250001；3.济南医院护理部，山东济南　250001；4.山东中医药大学附属医院药剂科，山东济南　250000

住院患者硫酸依替米星治疗后发生急性肾损伤的影响因素分析

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1.济南医院药剂科，山东济南250001；2.济南医院感染管理科，山东济南250001；3.济南医院护理部，山东济南250001；4.山东中医药大学附属医院药剂科，山东济南250000

目的研究硫酸依替米星致药物性肾损害的危险因素，为临床合理应用硫酸依替米星提供参考依据，减少肾损害的发生。方法查询我院2014年1月～2015年12月期间住院使用硫酸依替米星患者病历，共计789例。筛除不合格病例，最终入选63例。根据阿姆斯特丹AKI诊断标准，按治疗前、后Scr结果将出现急性肾损伤患者分为1组（n=6）和未发生急性肾损患者为2组（n=57）。采用SPSS 16.0软件进行统计分析。结果6例应用硫酸依替米星治疗后发生AKI的患者，各项指标变化差异均无统计学意义（P＞0.05）。单因素分析显示高血压可能与应用依替米星治疗后致急性肾损伤相关（P＜0.05）。结论硫酸依替米星为较为安全的氨基糖苷类抗菌药物，患有高血压的感染患者应用该药物时需加强肾功能监测。

依替米星；肾功能；药物性肾损害；急性肾损伤

［Abstract］Objective To explore the risk factors formedical renal impairment induced by etimicin sulfate，so as to provide references for clinical rational application of etimicin sulfate and reduce renal impairment.M ethods A total of 789 cases ofmedical recordswith the use of etimicin sulfate during hospitalization from January 2014 to December 2015 in our hospitalwere consulted.Unqualifiedmedical recordswere screened out，and 63 caseswere finally selected.According to Amsterdam AKI diagnostic criteria，the patientswith acute renal impairmentwere assigned to group 1（n=6）and the patientswith non-released acute renal impairmentwere assigned to group 2（n=57）via the Scr results before and after the treatment.SPSS16.0 software was applied for statistical analysis.The experiment results were represented by average number±standard deviation，andP＜0.05 represented the differences were statistically significant.Results In the 6 patients with AKI induced by the etimicin sulfate therapy，the changes of each index were not statistically significant（P＞0.05）.According to the univariate analysis，hypertension might be associated with acute renal impairment induced by etimicin therapy（P＜0.05）.Conclusion Etimicin sulfate is a relatively safe aminoglycosides antibiotics.Renal functionmonitoring should be strengthened while the patientswith hypertension and infection are using this drug.

［Key words］Etimicin；Renal function；Medical renal impairment；Acute renal impairment

氨基糖苷类抗生素依替米星与β内酰胺类抗生素有协同作用，与其他抗生素联合治疗重症感染有较好的临床疗效，且不易产生耐药［1-4］。其常见的不良反应为耳、肾不良反应，Ⅲ期临床试验结果显示其肾毒性发生率为1.3%［5，6］。……