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在结核病治疗中,利福平作为一线药物使用。其严重副作用包括肝细胞中毒性黄疸、免疫性血小板减少和溶血。1971年首次报道本药引致急性肾功能衰竭(ARF)。急性肾小管坏死和间质性肾炎是其主要病变,肾小球损害并不常见。作者观察到1例连续服用利福平6周后出现急进性肾小球肾炎(RPGN),并伴有肾病综合征和 ARF 的病例。患者男性,26岁,既往健康。诊断肺结核后采用异烟肼300mg/d、利福平600mg/d、吡嗪酰胺2g/d 及链霉素lg/d 治疗。连续治疗6周后出现浮肿及腹水。
Rifampicin is used as a first-line drug in tuberculosis treatment. Serious side effects include hepatotoxic toxic jaundice, immune thrombocytopenia and hemolysis. It was first reported in 1971 that this medicine caused acute renal failure (ARF). Acute tubular necrosis and interstitial nephritis is its major lesion, glomerular damage is not common. The authors observed 1 case of acute progressive glomerulonephritis (RPGN) with nephrotic syndrome and ARF after 6 weeks of continuous administration of rifampicin. Male patient, 26 years old, formerly healthy. After diagnosis of tuberculosis with isoniazid 300mg / d, rifampin 600mg / d, pyrazinamide 2g / d and streptomycin lg / d treatment. Edema and ascites appeared after 6 weeks of continuous treatment.