5例阿德福韦酯致肾小管损害继发低磷软骨症的药学监护

发布时间：2018-11-20 08:16

【摘要】：目的通过对5例阿德福韦酯引起肾小管损害继发低磷软骨症患者的临床特点、诊疗情况进行总结并结合文献资料,归纳出该类患者的药学监护要点。方法检索近年来国内外有关阿德福韦酯引起低磷软骨病的相关文献,并结合临床中5例患者的诊疗情况,指导该类患者进行正确的补磷以及相关指标的正确监测。结果阿德福韦酯致肾小管损害继发低磷软骨症的可能机制主要与基因缺陷相关,多见于小剂量(10 mg·d-1)服用1年以上,并随着时间延长,症状逐渐加重。通过停用阿德福韦酯或换用其他抗病毒药物,并予以补磷、补钙、补维生素D等对症治疗,可以达到良好的预后。结论阿德福韦酯致肾小管损害继发低磷软骨症,临床特征缺乏特异性,极易引起误诊,因此临床上应予以重视。
[Abstract]:Objective to summarize the clinical characteristics, diagnosis and treatment of 5 patients with hypophosphorous chondrosis secondary to renal tubular damage caused by adefovir dipivoxil. Methods in recent years, literature about adefovir dipivoxil induced hypophosphorous chondropathy was searched, and combined with the diagnosis and treatment of 5 patients in clinic, the patients were guided to correct phosphorus supplementation and monitoring. Results the possible mechanism of adefovir ester induced hypophosphorous chondrosis secondary to renal tubular damage was mainly related to gene defect. It was more common in low dose (10 mg d ~ (-1) for more than 1 year. A good prognosis can be achieved by stopping adefovir dipivoxil or replacing other antiviral drugs with supplementation of phosphorus calcium vitamin D and other symptomatic treatments. Conclusion adefovir ester induced hypophosphorous chondrosis secondary to renal tubule damage is characterized by lack of specificity and is easy to be misdiagnosed, so we should pay more attention to it in clinic.
【作者单位】：解放军总医院药品保障中心临床药学室;解放军总医院内分泌科;
【基金】：解放军总医院科技创新苗圃基金资助项目(13KMM46)
【分类号】：R692;R681.3

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