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1例54岁女性患者因冠心病间断口服冠心苏合胶囊10年,每年约200粒。最近患者因发热、呼吸道感染服用含对乙酰氨基酚感冒胶囊2粒/次,3次/d,并间断服用对乙酰氨基酚(总量约20粒)。用药2周后患者出现呕吐、少尿等,尿量减少至150mL/d。肾功能检查示SCr997.6μmol/L,BUN18.67mmol/L。确诊为急性间质性肾炎,急性肾衰竭,考虑与服用含马兜铃酸的中药冠心苏合胶囊及联合应用对乙酰氨基酚有关。停用所用药物,给予甲泼尼龙、血液透析等治疗,1个月后患者尿量增加至2000mL/d,其他指标基本恢复,出院。
A 54-year-old female patient received Guanxin Suhe capsule intermittently for coronary heart disease for 10 years, about 200 capsules per year. Patients recently due to fever, respiratory infections containing paracetamol cold capsules 2 capsules / time, 3 times / d, and intermittent paracetamol (about 20 tablets). After 2 weeks of treatment, the patient developed vomiting, oliguria, etc. The urine output was reduced to 150 mL / d. Renal function tests showed SCr997.6μmol / L, BUN18.67mmol / L. Confirmed as acute interstitial nephritis, acute renal failure, taking into account the use of aristolochic acid containing Chinese medicine Guanxin Suhe capsule and the combination of acetaminophen. Stop using the drugs, given methylprednisolone, hemodialysis and other treatment, 1 month after the patient’s urine volume increased to 2000mL / d, other indicators of basic recovery, discharged.