临床药师参与2例丙硫氧嘧啶致抗中性粒细胞胞浆抗体相关性血管炎的病例分析

发布时间：2018-04-16 09:39

本文选题：丙硫氧嘧啶 + ANCA相关性血管炎　；参考：《中国新药杂志》2017年05期

【摘要】：目的:探讨临床药师在丙硫氧嘧啶(propylthiouracil,PTU)诱发的抗中性粒细胞胞浆抗体相关性血管炎[anti-neutrophil cytoplasmic antibodies(ANCA)-associated vasculitis,AAV]多学科诊疗中的作用。方法:对某院收治的临床药师参与诊疗的2例PTU引起的AAV病例进行回顾性分析,总结PTU的致病规律及临床特点,探索临床诊断和药学关联性诊断关系,总结个体化药物治疗方案及药学监护重点。结果:PTU诱发的AAV潜伏期长,临床异质性大,可表现为皮肤、关节、肺、肾脏、消化道、骨髓损害,常有特征性免疫抗体异常,其临床诊断和药学关联性诊断相互补充,通过停药及使用糖皮质激素、环磷酰胺抗免疫治疗得到有效缓解。药师全程参与诊疗,有利于患者早期诊断和个体化治疗。结论:PTU诱发的AAV,早期不易临床诊断和识别诱发药物,临床表现及治疗个体差异大。临床药师早期、全程参与药源性疾病诊疗,能发挥不可替代的作用。
[Abstract]:Objective: to investigate the role of clinical pharmacists in the multidisciplinary diagnosis and treatment of anti-neutrophil cytoplasmic antibodies(ANCA)-associated vasculitis associated with propylthiouraciline (PTU) induced by propylthiouraciline (PTU).Methods: two cases of AAV caused by PTU were analyzed retrospectively. The pathogenicity and clinical characteristics of PTU were summarized, and the relationship between clinical diagnosis and pharmacological diagnosis was explored.To summarize the individualized drug therapy and the key points of pharmaceutical monitoring.Results AAV induced by 1: PTU had long latent period and large clinical heterogeneity. It could be characterized by skin, joint, lung, kidney, digestive tract and bone marrow damage.Cyclophosphamide anti-immunotherapy is effective by stopping medication and using glucocorticoid.Pharmacists participate in the whole diagnosis and treatment, which is beneficial to the early diagnosis and individualized treatment of patients.Conclusion it is difficult to diagnose and identify the evoked drugs in the early stage of AAVS induced by: 1% PTU, and there are great differences in clinical manifestations and treatment individuals.Early clinical pharmacists participate in the diagnosis and treatment of drug-induced diseases, can play an irreplaceable role.
【作者单位】：重庆医科大学附属第一医院药学部;重庆医科大学附属第一医院内分泌科;
【分类号】：R593.2

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