中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
8期
1208-1210
,共3页
氟喹诺酮类药物%左氧氟沙星%不良反应%药物性肝病%肝损伤
氟喹諾酮類藥物%左氧氟沙星%不良反應%藥物性肝病%肝損傷
불규낙동류약물%좌양불사성%불량반응%약물성간병%간손상
Fluoroquinolones%Levofloxacin%Adverse reactions%Drug-induced liver disease%Liver damage
目的 了解左氧氟沙星导致的严重不良反应的现状及特点.方法 对1例左氧氟沙星导致的严重不良反应患者的诊治经过进行回顾性分析并结合文献进行讨论.结果 患者应用左氧氟沙星第7天,出现恶心、欲吐,食欲差.第8天出现烦躁、心慌、身冷;心率增快,心率148次/min;血糖降低,为3.1 mmol/L;嗜酸粒细胞计数升高,0.5 × 109/L;肝功能异常,丙氨酸转氨酶3 111 U/L,天冬氨酸转氨酶192 U/L,总胆红素38.2 μmol/L,直接胆红素18.5 μmol/L;凝血功能异常,凝血酶原时间30.9 s,活化部分41.4 s,纤维蛋白原1.76 g/L.随后出现血小板计数明显下降,血小板计数43×109/L.给予输注血浆200 ml,补充凝血因子;复方甘草酸苷、还原型谷胱甘肽、舒肝宁等保肝及对症支持治疗,10 d后,患者好转出院,后门诊随访患者各项指标恢复正常.结论 左氧氟沙星导致的特异质反应可能会导致很高的发病率和病死率,在使用左氧氟沙星的时候,存在糖尿病、肝病或肝脏疾病风险的患者应谨慎使用,并密切监测肝功能,出现问题及时停药,避免导致致命的严重结果.
目的 瞭解左氧氟沙星導緻的嚴重不良反應的現狀及特點.方法 對1例左氧氟沙星導緻的嚴重不良反應患者的診治經過進行迴顧性分析併結閤文獻進行討論.結果 患者應用左氧氟沙星第7天,齣現噁心、欲吐,食欲差.第8天齣現煩躁、心慌、身冷;心率增快,心率148次/min;血糖降低,為3.1 mmol/L;嗜痠粒細胞計數升高,0.5 × 109/L;肝功能異常,丙氨痠轉氨酶3 111 U/L,天鼕氨痠轉氨酶192 U/L,總膽紅素38.2 μmol/L,直接膽紅素18.5 μmol/L;凝血功能異常,凝血酶原時間30.9 s,活化部分41.4 s,纖維蛋白原1.76 g/L.隨後齣現血小闆計數明顯下降,血小闆計數43×109/L.給予輸註血漿200 ml,補充凝血因子;複方甘草痠苷、還原型穀胱甘肽、舒肝寧等保肝及對癥支持治療,10 d後,患者好轉齣院,後門診隨訪患者各項指標恢複正常.結論 左氧氟沙星導緻的特異質反應可能會導緻很高的髮病率和病死率,在使用左氧氟沙星的時候,存在糖尿病、肝病或肝髒疾病風險的患者應謹慎使用,併密切鑑測肝功能,齣現問題及時停藥,避免導緻緻命的嚴重結果.
목적 료해좌양불사성도치적엄중불량반응적현상급특점.방법 대1례좌양불사성도치적엄중불량반응환자적진치경과진행회고성분석병결합문헌진행토론.결과 환자응용좌양불사성제7천,출현악심、욕토,식욕차.제8천출현번조、심황、신랭;심솔증쾌,심솔148차/min;혈당강저,위3.1 mmol/L;기산립세포계수승고,0.5 × 109/L;간공능이상,병안산전안매3 111 U/L,천동안산전안매192 U/L,총담홍소38.2 μmol/L,직접담홍소18.5 μmol/L;응혈공능이상,응혈매원시간30.9 s,활화부분41.4 s,섬유단백원1.76 g/L.수후출현혈소판계수명현하강,혈소판계수43×109/L.급여수주혈장200 ml,보충응혈인자;복방감초산감、환원형곡광감태、서간저등보간급대증지지치료,10 d후,환자호전출원,후문진수방환자각항지표회복정상.결론 좌양불사성도치적특이질반응가능회도치흔고적발병솔화병사솔,재사용좌양불사성적시후,존재당뇨병、간병혹간장질병풍험적환자응근신사용,병밀절감측간공능,출현문제급시정약,피면도치치명적엄중결과.
Objective To understand features of severe adverse reactions caused by levofloxacin.Methods Diagnosis and treatment of one case of levofloxacin induced serious adverse reaction were studied and the literature was reviewed.Results The patient had nausea,vomit and poor appetite after using levofloxacin for seven days.At the eighth day,he had irritability,flustered,cold and the heart rate increased to 148 times per minute; the blood glucose decreased to 3.1 mmol/L; the eosinophil count increased to 0.5 × 109/L; the liver function was abnormal; the alanine aminotransferase increased to 3 111 U/L; the aspartate aminotransferase increased to 192 U/L;the total bilirubin increased to 38.2 μmol/L and the direct bilirubin increased to 18.5 μmol/L.The coagulation function was abnormal.The prothrombin time increased to 30.9 s ; the activated partial thromboplastin time increased to 41.4 s and the fibrinogen increased to 1.76 g/L; the platelet countobviously decreased to 43 × 109/L.All the indexes had returned to normal.Conclusions The idiosyncratic reaction may result in significant morbidity and mortality.Patients who have diabetes,liver diseases or risk ofliver diseases should use levofloxacin with caution and liver function should be monitored closely.
