Wahlström O, Maller R, Djerf K, Ivarsson I
Department of Orthopedics, Faculty of Health Sciences, Linköping University Hospital, Sweden.
Acta Orthop Scand. 1992 Oct;63(5):539-42. doi: 10.3109/17453679209154732.
Two different isoxazolylpenicillins (cloxacillin and dicloxacillin) were compared regarding impairment of renal function after total hip arthroplasty. 85 patients received dicloxacillin and 93 patients received cloxacillin as antibiotic prophylaxis. A total dose of 6 grams was given during a 36-hour period in doses of 1 gram pre-, per- and postoperatively. Creatinine in serum and beta 2-microglobulin in serum and urine were determined preoperatively and 2, 4, and 10 days after the operation. The dicloxacillin-treated patients had an increase in creatinine and beta 2-microglobulin in serum that was not seen in the cloxacillin group. The increase indicates a transient injury in the process of glomerular filtration. Although the increase was temporary and subclinical, a dose reduction is nevertheless recommended for older patients.
比较了两种不同的异恶唑基青霉素（氯唑西林和双氯西林）在全髋关节置换术后对肾功能的损害情况。85例患者接受双氯西林，93例患者接受氯唑西林作为抗生素预防用药。在36小时内共给予6克剂量，术前、术中及术后各给予1克。术前以及术后2天、4天和10天测定血清肌酐以及血清和尿液中的β2-微球蛋白。接受双氯西林治疗的患者血清肌酐和β2-微球蛋白升高，而氯唑西林组未出现这种情况。这种升高表明肾小球滤过过程中存在短暂损伤。尽管这种升高是暂时的且为亚临床状态，但仍建议老年患者减少剂量。
