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目的探讨阿昔洛韦致急性肾功能衰竭(ARF)的主要原因及防治措施。方法回顾性分析我科2000—2012年收治的阿昔洛韦所致ARF的患者20例。结果经停药、水化、碱化尿液、积极对症治疗,其中3例少尿型ARF患者,予血液透析治疗,20例患者全部痊愈出院。结论阿昔洛韦致ARF为速发型,以非少尿型为主,主要由于不合理用药所致,如超出本药临床应用范围给药、用药剂量过大、速度过快、浓度过大、药物配伍不正确(如与肾毒性药联用),用药后没给予足够量的水化等。临床医生严格掌握用药指征,确保合理用药,规范合理用药是预防的关键。
Objective To investigate the main causes and prevention and treatment of acyclovir-induced acute renal failure (ARF). Methods A retrospective analysis of 20 cases of ARF induced by acyclovir in our department from 2000 to 2012 was retrospectively analyzed. Results After discontinuation, hydration and alkalinization of urine, positive symptomatic treatment was performed. Among them, 3 patients with oliguric ARF were treated with hemodialysis and all 20 patients were discharged. CONCLUSIONS: ARF induced by acyclovir is predominantly fast-onset and mainly of non-oliguric type, which is mainly caused by irrational drug use. For example, the dosage of acyclovir is beyond the scope of clinical application, the dosage is too large, the rate is too fast, and the concentration is too large. Drug compatibility is not correct (such as combined with nephrotoxic drugs), did not give adequate hydration and so on after treatment. Clinicians to strictly grasp the indications for medication to ensure rational use of drugs, regulate the rational use of drugs is the key to prevention.