Wagner Robert, Leicht-Biener Ursel, Mucsi István, Seitz Karlheinz
Department of Internal Medicine, Sigmaringen Community Hospital, Sigmaringen, Germany.
Scand J Urol Nephrol. 2012 Feb;46(1):65-9. doi: 10.3109/00365599.2011.625041. Epub 2011 Oct 13.
In many parts of Europe, nephropathia epidemica (NE) is an endemic zoonosis. After a flu-like prodrome, this viral disease often manifests with acute kidney injury. Use of non-steroidal anti-inflammatory drugs is discouraged during the disease, but no data from clinical investigations are available on the association between disease course and the use of analgesics.
The charts of 59 patients admitted with NE to a hospital in 2007 were retrospectively analysed. Creatinine levels were compared between users of different analgesics.
Patients taking analgesics before admission had higher peak creatinine levels, but not after adjustment for confounders. The subgroup taking ibuprofen or diclofenac had higher initial and peak creatinine levels than the group who did not, even after adjustment for confounders.
Since NE cannot be accurately diagnosed in the early disease phase, metamizole, acetaminophen or acetylsalicylic acid may be preferable analgesics to ibuprofen or diclofenac for flu-like symptoms in endemic areas.
在欧洲许多地区，流行性肾病（NE）是一种地方性人畜共患病。在出现类似流感的前驱症状后，这种病毒性疾病常表现为急性肾损伤。患病期间不建议使用非甾体抗炎药，但尚无临床研究数据表明疾病进程与镇痛药使用之间的关联。
回顾性分析了2007年一家医院收治的59例NE患者的病历。比较了不同镇痛药使用者的肌酐水平。
入院前服用镇痛药的患者肌酐峰值水平较高，但在对混杂因素进行调整后则不然。服用布洛芬或双氯芬酸的亚组患者，即使在对混杂因素进行调整后，其初始肌酐水平和峰值肌酐水平仍高于未服用者。
由于在疾病早期无法准确诊断NE，在流行地区，对于类似流感的症状，安乃近、对乙酰氨基酚或阿司匹林可能是比布洛芬或双氯芬酸更合适的镇痛药。
