中国药物应用与监测
中國藥物應用與鑑測
중국약물응용여감측
CHINESE JOURNAL OF DRUG APPLICATION AND MONITORING
2014年
1期
55-56,57
,共3页
沙利度胺%月经不调%药品不良反应
沙利度胺%月經不調%藥品不良反應
사리도알%월경불조%약품불량반응
Thalidomide%Irregular menstruation%Adverse drug reaction
1例28岁女性患者，主诉左膝关节肿痛3年，腰背痛及左髋关节疼痛2年。左膝关节肿痛起病，腰背痛伴有晨僵及夜间痛，双足跟疼痛，无虹膜炎及强直性脊柱炎（AS）家族史。化验HLA-B27阳性，ESR 36 mm·h-1，CRP 3.48 mg·dL-1，骶髂关节CT示双侧骶髂关节虫蚀样改变，诊断为强直性脊柱炎，给予洛索洛芬钠及柳氮磺吡啶治疗后，患者左髋关节疼痛好转，但腰背痛症状改善不明显，加用沙利度胺（50 mg，qn），2周后给药剂量调至100 mg，qn。服用4个月后，腰背痛症状明显减轻，晨僵及夜间痛消失，但逐渐出现月经量减少至停经，停用沙利度胺2个月后症状好转。
1例28歲女性患者，主訴左膝關節腫痛3年，腰揹痛及左髖關節疼痛2年。左膝關節腫痛起病，腰揹痛伴有晨僵及夜間痛，雙足跟疼痛，無虹膜炎及彊直性脊柱炎（AS）傢族史。化驗HLA-B27暘性，ESR 36 mm·h-1，CRP 3.48 mg·dL-1，骶髂關節CT示雙側骶髂關節蟲蝕樣改變，診斷為彊直性脊柱炎，給予洛索洛芬鈉及柳氮磺吡啶治療後，患者左髖關節疼痛好轉，但腰揹痛癥狀改善不明顯，加用沙利度胺（50 mg，qn），2週後給藥劑量調至100 mg，qn。服用4箇月後，腰揹痛癥狀明顯減輕，晨僵及夜間痛消失，但逐漸齣現月經量減少至停經，停用沙利度胺2箇月後癥狀好轉。
1례28세녀성환자，주소좌슬관절종통3년，요배통급좌관관절동통2년。좌슬관절종통기병，요배통반유신강급야간통，쌍족근동통，무홍막염급강직성척주염（AS）가족사。화험HLA-B27양성，ESR 36 mm·h-1，CRP 3.48 mg·dL-1，저가관절CT시쌍측저가관절충식양개변，진단위강직성척주염，급여락색락분납급류담광필정치료후，환자좌관관절동통호전，단요배통증상개선불명현，가용사리도알（50 mg，qn），2주후급약제량조지100 mg，qn。복용4개월후，요배통증상명현감경，신강급야간통소실，단축점출현월경량감소지정경，정용사리도알2개월후증상호전。
One 28-year-old young female saw a doctor due to left knee joint pain and swelling for three years, low back pain and left hip pain for two years. The patient had left knee joint pain and swelling, low back pain accompanied by morning stiffness and nocturnal back pain, as well as double heel pain. The patient had no history of iritis and family history of the ankylosing spondylitis (AS). HLA-B27 was positive, erythrocyte sedimentation rate was 36 mm·h-1, C-reactive protein was 3.48 mg·dL-1, and sacroiliac joint CT showed bilateral sacroiliac joints erosion change. The patient was diagnosed with AS. Loxoprofen sodium and sulfasalazine were given. The symptom of left hip pain improved after the treatment, but the low back pain did not obviously relieve. Then thalidomide was given orally with the dose of 50 mg every night, and the dose was added to 100 mg after 2 weeks. Four months later, the symptom of low back pain signiifcantly improved, morning stiffness and nocturnal back pain disappeared. But menstrual blood volume of the patient decreased gradually and subsequently the patient developed amenorrhea. Transvaginal ultrasonography showed normal. The symptoms improved after withdrawl of thalidomide for 2 months.
