目的：探讨一例2型糖尿病合并高血压病、肾功能不全患者入院后血肌酐变化的药物影响因素，并提出预防措施。方法：临床药师通过结合病历，查阅文献资料，对1例2型糖尿病合并高血压病、肾功能不全患者入院后血肌酐变化的药物因素进行评价、分析并干预。结合患者并发的基础疾病和使用的药物，提出药学建议，制定日后同类风险预防措施，提供药学服务。结果：该患者入院诊断为2型糖尿病，合并高血压病、肾功能不全等基础疾病，同时院内使用过培哚普利、奥美沙坦酯、托拉塞米、二甲双胍、碘普罗胺造影剂等存在肾损害或诱发肾损害的药物，是患者血肌酐升高的重要因素。结论：临床药师在诊疗活动中及时、准确地发现与药物相关的不良事件，评估风险，提出优化的治疗方案，可保证药物治疗的安全性和有效性。%OBJECTIVE:To investigate the drug-related factors influencing serum creatinine level in one patient with type 2 diabetes complicating hypertension and renal insufficiency after admission, and propose preventive measures.METHODS: By reviewing patients'medical records and literature review, clinical pharmacists performed evalution, analysis and intervention on drug-related factors influencing serum creatinine level in one patient with type 2 diabetes complicating hypertension and renal dysfunction after admission, put forward pharmaceutical suggestions based on patients underlying diseases and the drugs administered, formulated preventive measures against the similar risks and provided pharmaceutical care.RESULTS: The patient on admission was diagnosed as having such underlying diseases as type 2 diabetes complicating hypertension and renal insufficiency etc and received such drugs including perindopril, olmesartan medoxomil, torasemide, metformin, Iopromide contrast medium etc that might cause or induce renal damage.These drugs were the important factors for elevated serum creatinine level.CONCLUSIONS: Clinical pharmacist promptly and accurately find drug-related adverse events during diagnosis and treatment activities, assess risks, propose optimized treatment regimen can guarantee the safety and effectiveness of drug treatment.
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