目的：调查了解国内克林霉素致急性肾损伤( acute kidney injury, AKI)的现状,为临床医师合理用药提供参考依据。方法以“克林霉素+AKI或药物不良反应”为检索式,检索中国知网2010—2014年中文医学期刊中克林霉素导致AKI的相关文献,对符合标准的文献进行信息记录并采用Excel软件进行数据统计汇总和分析。结果共纳入文献23篇425例患者；首发症状均为恶心、呕吐、乏力、腰腹部疼痛并伴有肉眼血尿甚至酱油样尿；原发疾病多为上呼吸道感染,其次为胃肠炎、牙龈炎、咽炎等；给药途径均为静脉滴注；用药剂量0.9~2.7 g/d,输注浓度6~12 g/L；部分联合用药；AKI发生时间：用药后20 min~7 d。确诊后经停药、对症处理,并酌情给予血液透析治疗,424例痊愈,肾功能恢复正常时间7~150 d；1例因急性肾衰竭死亡。结论克林霉素致AKI几乎均发生于静脉滴注时,发病时间集中在用药后20 min~7 d,引发原因与个体、用药剂量浓度等诸多因素有关。提示临床医师应谨慎按照药品说明书给药,给药过程中应严密观察患者尿量及肾功能变化,以及早发现AKI。%Objective To investigate of clindamycin induced acute kidney injury ( acute kidney injury, AKI) , and to provide reference basis for rational use of drugs. Methods The adverse reactions of clindamycin and AKI or drugs were as the search type. CNKI during 2010 and 2015 about clindamycin leading to AKI was retrieved, and literature of a total of 23 ar-ticles was included. Summary and analysis of all the information were recorded in the Excel software. Results Clindamycin resulted in a total of 425 cases of AKI;primary diseases of the patients were upper respiratory tract infection, gastroenteritis, gingivitis, pharyngitis, bronchiectasis with infection, otitis media and so on; route of administration was intravenous drip;dose 0. 9-2. 7 g/d, concentration 6-12 mg/ml;AKI occurred at 20 min-7 d after administration. All the patients stopped using clindamycin, after confirmed diagnosis and symptomatic treatment was given. 424 cases were cured. Renal function recovered 7-150 d;1 patient died of acute renal failure. Conclusion Almost all cases of AKI occurred during clindamycin intravenous drip, the onset time is 20 min-7 d after administration. The cause is related to many factors, such as the individual and the dose of drug. Doctors are advised to follow the instructions carefully. In the course of administration, the physicians should observe the changes of urine volume and renal function closely, so as to detect AKI as early as possible.
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