URINARY CASTS AS AN INDICATOR OF RENAL TUBULAR DAMAGE IN PATIENTS RECEIVING AMINOGLYCOSIDES
URINARY CASTS AS AN INDICATOR OF RENAL TUBULAR DAMAGE IN PATIENTS RECEIVING AMINOGLYCOSIDES
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DOI：
10.1128/aac.16.4.468
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发表时间：
1979-01-01
影响因子：
4.9
通讯作者：
JUSKO, WJ
中科院分区：
文献类型：
--
作者：
SCHENTAG, JJ;GENGO, FM;JUSKO, WJ
对154例重症患者进行了定量管型排泄作为肾小管损害早期标志物的价值评估。其中，124例接受氨基糖苷类抗生素[庆大霉素、福布霉素、阿米卡星或奈替米星用于治疗革兰氏阴性菌感染]，124例患者中有30例在治疗期间血清肌酐升高0.5 mg/dl或以上。154例患者中的其余30例接受其他抗生素治疗并作为对照。在早晨利尿剂给药前随机收集尿液，定量管型。对照组病人的管型计数平均为44 . ±.在重症监护室里打了51个石膏。给予氨基糖苷类药物而血清肌酐无显著升高（≥ 0.5 mg/dl）的患者排泄153 ± 0.5 mg/dl。196个铸件，明显多于对照组。与对照组和非中毒组相比，30例肾中毒患者排出的管型明显更多（625 ± 0.05）。364)并且早在血清肌酐首次升高前9天显著更高。每日尿管型计数是一种快速和廉价的手段，以确定早期肾小管损害的危重病人给予氨基糖苷类。
The value of quantitative cast excretion was assessed as an early marker of renal tubular damage in 154 seriously ill patients. Of these, 124 received aminoglycoside antibiotics [gentamicin, fobramycin, amikacin or netilmicin given for gram-negative infections], and 30 of the 124 experienced a rise in serum creatinine of 0.5 mg/dl or more during therapy. The remaining 30 of the 154 patients were treated with other antibiotics and served as controls. Casts were quantitated in random urines collected before morning diuretic doses. Cast counts in control patients averaged 44 .+-. 51 casts during the intensive care unit admission. Patients given aminoglycosides without a significant rise in serum creatinine of 0.5 mg/dl or more excreted 153 .+-. 196 casts, significantly more than controls. Compared to both the control and nontoxic patients, the 30 nephrotoxic patients excreted significantly more casts (625 .+-. 364) and were significantly higher as early as 9 days before serum creatinine first rose. Daily urinary cast counts as a rapid and inexpensive means of identifying early renal tubular damage in critically ill patients given aminoglycosides.