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作者报告麻省总医院三年来5例资料完整的,与先锋霉素Ⅰ治疗有关的急性肾功能衰竭病例。作者认为先锋霉素Ⅰ是急性肾功能衰竭一个肯定但少见的原因。所有5例病人的肾功能都在先锋霉素Ⅰ开始治疗后3～10天恶化,并于停药后1～11天内自行好转。在无其它肾功能减退原因的情况下,此一密切有关的时间上的关系,强力提示先锋霉素Ⅰ治疗是肾功能暂时性减退的真正原因。然而,在复杂的临床情况下,在未对药物作触发试验时,通常无法证明某一药物是引起观察到的中毒性或变态反应性作用的原因。
The authors report five cases of complete renal failure with acute nephrotic failure associated with the treatment with celecoxib in the three years at Massachusetts General Hospital. The author believes that cephalosporin I is a definite but uncommon cause of acute renal failure. All 5 patients had worsening of renal function 3 to 10 days after the start of treatment with cephamycin I and self-improvement within 1 to 11 days after withdrawal. In the absence of other causes of renal dysfunction, this closely related time strongly suggests that neoheparin I treatment is the real cause of transient renal impairment. However, in a complex clinical setting, it is often not possible to prove that a drug is causing the observed toxic or allergic effects without triggering the drug.