Houghton D C, Campbell-Boswell M V, Bennett W M, Porter G A, Brooks R E
Clin Nephrol. 1978 Oct;10(4):140-5.
Ultrastructural changes in renal proximal tubule lysosomes, including the formation of myeloid bodies, occur reliably with gentamicin administration in experimental animals. The present study reviewed the electron microscopic tubular morphology of renal biopsies and nephrectomies performed in our institution over a 2-year period. The frequency of myeloid bodies and their relation to drug therapy and selected clinical features were determined. Myeloid bodies were found in the proximal tubules of 19 of 109 cases that were judged adequate for study. On review of the drug histories of these 19 patients, 15 had received gentamicin within 6 weeks of biopsy or nephrectomy. None of the 90 patients without myeloid bodies had received the drug within 6 weeks of tissue examination. Of 4 patients with myeloid bodies who had not received gentamicin, 1 had received chloroquin and 3 had received drugs with no known or suspected capacity to induce myeloid bodies. The presence of myeloid bodies in proximal tubules did not appear to be related to the total dose of gentamicin, duration of therapy, or serum drug concentration. Clinical evidence of gentamicin nephrotoxicity was present in only 1 case.
在实验动物中，给予庆大霉素后，肾近端小管溶酶体会出现超微结构变化，包括髓样小体的形成。本研究回顾了本机构在两年期间进行的肾活检和肾切除标本的电子显微镜下肾小管形态。确定了髓样小体的出现频率及其与药物治疗和选定临床特征的关系。在109例被判定适合研究的病例中，有19例在近端小管中发现了髓样小体。在回顾这19例患者的用药史时，有15例在活检或肾切除术前6周内接受过庆大霉素治疗。在90例没有髓样小体的患者中，没有一例在组织检查前6周内接受过该药物治疗。在4例有髓样小体但未接受庆大霉素治疗的患者中，1例接受过氯喹治疗，3例接受过无已知或可疑诱导髓样小体能力的药物治疗。近端小管中髓样小体的出现似乎与庆大霉素的总剂量、治疗持续时间或血清药物浓度无关。仅1例有庆大霉素肾毒性的临床证据。
