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在综合性医院,有22％急性肾功能衰竭病例系庆大霉素所致。作者观察37例患者应用庆大霉素前、后其内生肌酐清除率,血肌酐、血尿素氮、24小时尿钠、钾排出量,以及使用庆大霉素前及用药后6天,停药后5、11、17天尿N-乙酰-β-D氨基葡萄糖苷葡(NAG)活性。其庆大霉素剂量为每日32万u者9例、24万u19例、16万u 9例,疗程为7～8天,静脉滴注。检测结果发现,治疗剂量的庆大霉素对肾小球和肾小管已有损害。提醒临床医师在使用庆大霉素时,必须严格掌握指征,在用药过程中加强对肾功能的监护。对伴有脱水的患者、电解质紊乱及原有NAG明显增高者,尤需注意。
In general hospitals, 22% of acute renal failure cases caused by gentamicin. The authors observed 37 patients before and after the application of gentamicin endogenous creatinine clearance rate, serum creatinine, blood urea nitrogen, 24-hour urine sodium and potassium excretion, and the use of gentamicin before and after 6 days, stop Urine N-acetyl-β-D-glucosaminoglycans (NAG) activity at 5, 11 and 17 days after treatment. The gentamicin dose of 320,000 u per day in 9 cases, 240,000 u19 cases, 160,000 u 9 cases, treatment for 7 to 8 days, intravenous drip. Test results showed that the therapeutic dose of gentamicin on the glomeruli and tubules have been damaged. Remind clinicians in the use of gentamicin, we must strictly control the indications, strengthen the monitoring of renal function in the course of medication. In patients with dehydration, electrolyte imbalance and the original NAG was significantly higher, with particular attention.