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目的 :探讨奈替米星治疗后对老年患者早期肾功能的影响。方法 :测定 36例经奈替米星治疗老年患者用药前和用药后第 7天血转铁蛋白 (TRF)、β2 微球蛋白 (β2 MG)和肌酐 (Cr) ,尿微量白蛋白 (mAlb)和尿α1 微球蛋白 (α1 MG)。用药第 7天检测奈替米星血药谷、峰浓度。结果 :用药前血TRF、β2 MG、Cr,尿mAlb、尿mAlb/Cr、尿α1 MG及α1 MG/Cr分别为 (2 .5 4± 0 .2 1)g/L、(3.2 4± 1.75 )mg/L、(6 1.92± 15 .77) μmol/L、(4 1.5 8± 5 2 .4 3)mg/L、(12 .2 0± 14 .79)g/mol、(35 .2 1± 2 7.11)mg/L和 (12 .5 2± 10 .0 7)g/mol;用药后分别为 (2 .5 6± 0 .35 )g/L、(3.4 8± 1.70 )mg/L、(6 2 .5 0±17.39) μmol/L、(4 2 .86± 6 2 .10 )mg/L、(13.2 1± 14 .7)g/mol、(4 0 .71±2 8.31)mg/L和 (15 .98± 12 .4 3)g/mol。治疗后血TRF、β2 MG、Cr和尿mAlb较治疗前的差别无显著性 (P >0 .0 5 ) ;治疗后尿α1 MG、尿mAlb/Cr和尿α1 MG/Cr较治疗前升高 ,有统计学差异 (P <0 .0 5 ,<0 .0 5 ,<0 .0 1)。奈替米星血药峰、谷浓度分别为 (6 .6 9± 2 .2 7)、(0 .4 8± 0 .4 3) μg/ml。结论 :血尿系列微量蛋白可作为老年患者奈替米星治疗期早期肾毒性的标志物。
Objective: To investigate the effect of netilmicin on the early renal function in elderly patients. Methods: The levels of serum TRF, β2 MG and creatinine (Cr) and urine microalbumin (mAb) in 36 elderly patients treated with netilmicin before and after treatment with netilmicin were measured. And urinary α1 microglobulin (α1 MG). The 7th day of drug testing netilmicin blood valley, peak concentration. Results: The blood levels of TRF, β2 MG, Cr, urine mAlb, urine mAlb / Cr, urine α1 MG and α1 MG / Cr were (2.45 ± 0.21) g / L and ) (6 1.92 ± 15.77) μmol / L, (4 1.58 ± 5.24.3) mg / L, (12.2 ± 14.79) g / mol, 1 ± 2 7.11) mg / L and (12.52 ± 10 .0 7) g / mol, respectively; after treatment, they were (2.56 ± 0.35) g / L, (62.5 ± 17.39) μmol / L, (42.86 ± 62.2) mg / L, (13.2 1 ± 14.7) g / mol, ) mg / L and (15 .98 ± 12 .4 3) g / mol. After treatment, there were no significant differences in TRF, β2 MG, Cr and urine mAlb between before treatment and after treatment (P> 0.05); after treatment, urinary α1 MG, urine mAlb / Cr and urinary α1 MG / Cr increased , There was statistical difference (P <0.05, <0.05, <0.01). The plasma concentrations of netilmicin were (6. 69 ± 2. 27) and (0. 48 ± 0. 43) μg / ml, respectively. Conclusion: Hematuria microalbumin can be used as a marker of early nephrotoxicity in elderly patients treated with netilmicin.