Bygbjerg I C, Moller R
Scand J Infect Dis. 1976;8(3):203-8. doi: 10.3109/inf.1976.8.issue-3.16.
162 consecutive gentamicin courses have been evaluated retrospectively with respect to nephrotoxicity of gentamicin (GM). Of these, 120 courses were administered in 106 patients for more than 2 days and under adequate control of plasma creatinine (PCr). In 62 of these 120 courses, PCr concentrations increased. In 17 courses (14%), GM therapy was found to be the only demonstrable etiology to the rise in PCr. The 17 courses with GM-induced reduction in kidney function were characterized by a prolonged duration of treatment, a high total dose of GM and a somewhat higher level of serum GM than the 58 courses of GM treatment in which PCr remained unchanged. No significant differences were found with regard to age, average daily dose of GM, average daily dose per kg and average daily dose in proportion to average diuresis. Additional administration of other nephrotoxic drugs did not increase the incidence of GM-induced nephropathy. When GM was the only demonstrable cause of nephropathy, the elevation in PCr concentrations were generally mild and transient, while the nephropathy when other factors were involved more often became severe and occasionally irreversible.
我们对162个连续的庆大霉素疗程进行了回顾性评估，以研究庆大霉素（GM）的肾毒性。其中，106例患者接受了120个疗程的治疗，疗程超过2天且血浆肌酐（PCr）得到充分监测。在这120个疗程中，有62个疗程的PCr浓度升高。在17个疗程（14%）中，发现GM治疗是PCr升高的唯一可证实病因。与PCr未发生变化的58个GM治疗疗程相比，17个因GM导致肾功能减退的疗程具有治疗时间延长、GM总剂量高以及血清GM水平略高的特点。在年龄、GM平均日剂量、每千克平均日剂量以及与平均尿量成比例的平均日剂量方面，未发现显著差异。额外使用其他肾毒性药物并未增加GM所致肾病的发生率。当GM是肾病的唯一可证实病因时，PCr浓度升高通常较为轻微且短暂，而当涉及其他因素时，肾病往往更为严重，偶尔甚至不可逆转。
