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目的:调查长程使用氨基糖苷类药物的耳毒性及肾毒性。 设计:评估至少接受14天氨基糖苷类药物治疗的结核病患者听力障碍及肾毒性。 结果:在使用氨基糖苷类药物(阿米卡星,卡那霉素,及/或链霉素)观察的总人群中,发现18％患者有2个或更多音频15分贝的听力下降或至少一个音频有20分贝的听力下降。卡那霉素治疗组发生率为15.6％。未发现性别、年龄、治疗期限、氨基糖苷剂量或首次血清肌酐值等因素与听力障碍有关。氨基糖苷类药物或卡那霉素治疗结束时,按血清肌酐增加≥27umol/L(或≥44umol/L)标准,肾毒性发生率各为7.5％(1.9％)及4.5％(2.3％)。发生肾毒性的患者多为接受较长期治疗及总计量较大者。 结论:发生肾毒性反应的患者多为接受较长疗程和较大剂量的氨基糖苷类药物治疗者。但本研究未发现与听力障碍发生的有关因素。长程采用氨基糖苷类药物治疗结核病时,耳毒性的问题多于肾毒性反应。
Objective: To investigate ototoxicity and nephrotoxicity of long-term use of aminoglycosides. Design: Assessment of hearing impairment and nephrotoxicity in tuberculosis patients receiving at least 14 days of aminoglycoside treatment. Results: Of the total population observed using aminoglycosides (amikacin, kanamycin, and / or streptomycin), 18% of patients were found to have 2 or more hearing loss of audio 15 dB or at least An audio has a 20 decibel hearing loss. The incidence of kanamycin treatment group was 15.6%. No gender, age, duration of treatment, aminoglycoside dose or initial serum creatinine were found to be associated with hearing impairment. At the end of treatment with aminoglycosides or kanamycin, the incidence of nephrotoxicity was 7.5% (1.9%) and 4.5% (2.3%), respectively, according to the serum creatinine increase ≥27umol / L (or ≥44umol / L) Nephrotoxicity occurred in patients receiving more long-term treatment and the total amount of the larger. Conclusion: Most of the patients who developed nephrotoxicity were aminoglycosides who took a longer course and larger doses. However, this study found no relevant factors of hearing impairment. Long-term use of aminoglycosides in the treatment of tuberculosis, ototoxicity than the nephrotoxic response.