摘要
目的:探讨达比加群酯相关肾损伤的临床特点及其防治,为安全用药提供参考。方法:检索PubMed、Ovid、Web of Science、Embase、Springer-link、Wiley Oline Library、CNKI、万方数据库和维普数据库,收集达比加群酯相关肾损伤的文献,检索时限均为建库截至2019年1月,提取相关数据进行分析。结果:初筛相关文献156篇,最终纳入符合标准的文献14篇,均来自国外期刊。14篇文献包括达比加群酯相关肾损伤患者14例,其中男9例,女5例;年龄59~89岁,中位年龄为80岁;临床表现主要为出血,其中以血尿为主;在达比加群酯相关肾损伤治疗后,4例肾功能恢复,4例肾功能改善,3例肾功能未恢复,3例肾功能恶化。结论:达比加群酯可能导致肾损伤,在肾损伤相关疾病的基础上也可能导致达比加群酯毒性增加,在出现危及生命的出血的紧急情况下血液透析不一定能达到很好疗效,可使用达比加群酯逆转剂——依达赛珠单抗(idarucizumab)解毒。临床在使用时,应权衡药物使用的利弊,以及时应对不良反应的防治、发生及处理。
OBJECTIVE To explore the clinical characteristics,prevention and treatment of dabigatran etexilate-related renal injury,so as to provide reference for safe drug use.METHODS PubMed,Ovid,Web of Science,Embase,Springer-link,Wiley Oline Library,CNKI,wanfang database and weipu database were searched from inception to to January 2019 to collect literatures on dabigatran etexilate-related kidney injury,and relevant data are extracted for analysis.RESULTS 156 related documents were initially screened,and 14 articles that met the criteria were finally included,all of which were from foreign journals.14 literatures included 14 patients with dabigatran etexilate related renal injury,including 9 males and 5 females,aged 59~89 years,with median age of 80 years;The main clinical manifestation was hemorrhage,which was mainly hematuria;After dabigatran etexilate-related renal injury treatment,4 cases showed recovery of renal function,4 cases showed improvement of renal function,3 cases showed no recovery of renal function and 3 cases showed deterioration of renal function.CONCLUSION Dabigatran etexilate may cause renal injury,which may also lead to increased toxicity of dabigatran etexilate based on conditions associated with renal impairment.Hemodialysis may not be effective in emergency situations where life-threatening bleeding occurs,and the dabigatran etexilate reversal agent,idarucizumab,may be used for detoxification.In clinical use,it is necessary to weigh the advantages and disadvantages of drug use and timely deal with the prevention,occurrence and treatment of adverse reactions.
作者
孙立波
刘鑫
胡雪
宋燕青
李艳娇
SUN Li-bo;LIU Xin;HU Xue;SONG Yan-qing;LI Yan-jiao(Department of Pharmacy,the First Hospital of JilinUniversity,Jilin Changchun 130021,China)
出处
《中国医院药学杂志》
CAS
北大核心
2020年第2期194-198,共5页
Chinese Journal of Hospital Pharmacy
关键词
达比加群酯
肾损伤
伊达赛珠单抗
定性系统评价
dabigatran etexilate
kidney injury
idarucizumab
qualitative system evaluation
