阿莫西西林晶和阿莫西西林诱导的晶性病:一个叙述性综述
Dominique Vodovar1, Cyril Mousseaux2, Michel Daudon3
1Centre Anti-Poison de Paris, Hôpital Fernand Widal, AP-HP, Paris, France; Inserm UMR S 1144, Faculté de Pharmacie, Paris, France; Université Paris Cité, UFR de médecine, Paris, France.
Kidney international
|November 4, 2024
概括
阿莫西西林结晶性尿病 (AC) 和阿莫西西林诱导的结晶性病 (AICN) 比以前认为的更为常见,特别是高剂量静脉注射阿莫西西林. 及时诊断和管理对于脏恢复至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
- 内部医学 内部医学
背景情况:
- 氨基西林结晶尿 (AC) 是氨基西林在尿液中的沉;氨基西林诱导的结晶 (AICN) 是这些结晶阻塞管,导致急性损伤.
- AC和AICN被认为是罕见的,但在高剂量静脉注射阿莫西西林 (≥150 mg/kg/天) 时更为频繁.
研究的目的:
- 审查阿莫西西林结晶性病和阿莫西西林诱导的结晶性病的流行,诊断和治疗.
- 为了突出AC和AICN在接受高剂量静脉注射阿莫西西林的患者中发生率的增加.
主要方法:
- 关于阿莫西西林晶体病和晶体病的文献综述.
- 对AC和AICN的流行数据和风险因素的分析.
- 对AICN的诊断挑战和管理策略的总结.
主要成果:
- AC的患病率在24%至41%之间;AICN的患病率不清楚.
- AC通常无症状,但宏观血暗示了诊断. 诊断包括检测阿莫西西林三水合物晶体.
- 在排除其他原因后,在急性损伤和AC患者中怀疑AICN,特别是在接受高剂量IV阿莫西西林的患者中.
结论:
- AC是急性损伤的危险因素. 在没有非侵入性工具的情况下,诊断AICN是具有挑战性的.
- 治疗包括减少阿莫西西林剂量和液体复苏. 大多数患者的功能恢复,但10%-40%可能需要替代疗法.
- 需要进一步的研究来确定AC/AICN的确切患病率,并优化治疗.
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