论文部分内容阅读
1例31岁女性患者因溃疡性结肠炎给予美沙拉嗪1 g口服、3次/d治疗。治疗前血清肌酐（Scr）78 μmol/L。5个月后血尿素（BUN）8.3 mmol/L，Scr 185 μmol/L，估算肾小球滤过率（eGFR）31 ml/（min·1.73 mn 2）。肾穿刺活检病理学检查示急性小管间质性肾炎、肾小球球性硬化。考虑可能为美沙拉嗪所致肾损伤，停用该药。停药26 d后，BUN 4.0 mmol/L，Scr 130 μmol/L，eGFR 47 ml/（min·1.73 mn 2），加用醋酸泼尼松30 mg/d，2个月后减量至15 mg/d。复查示BUN 5.5 mmol/L，Scr 93 μmol/L，eGFR 71 ml/（min·1.73 mn 2）。n “,”A 31-year-old female patient took mesalazine 1 g thrice daily orally for colitis gravis. Her serum creatinine (Scr) was 78 μmol/L before medication. Five months later, her blood urea (BUN) was 8.3 mmol/L, Scr was 185 μmol/L, and estimated glomerular filtration rate (eGFR) was 31 ml/(min·1.73m n 2). Pathological examination of renal biopsy showed acute tubulointerstitial nephritis and glomerulosclerosis. Kidney injury related to mesalazine was considered. Then the drug was stopped. After 26 days of mesalazine withdrawal, laboratory tests showed BUN 4.0 mmol/L, Scr 130 μmol/L, and eGFR 47 ml/(min·1.73 m n 2). Prednisone acetate 30 mg daily was given and the dose was decreased to 15 mg daily 2 months later. Then laboratory tests showed BUN 5.5 mmol/L, Scr 93 μmol/L, and eGFR 71 ml/(min·1.73 m n 2).n