中国执业药师
中國執業藥師
중국집업약사
CHINA LICENSED PHARMACIST
2014年
8期
55-56
,共2页
抗结核药%药物超敏反应综合征%不良反应
抗結覈藥%藥物超敏反應綜閤徵%不良反應
항결핵약%약물초민반응종합정%불량반응
Antituberculosis Agent%Drug-induced Hypersensitivity Syndrome%Adverse Reaction
1例34岁女性肺结核患者，予口服四联抗结核药治疗（异烟肼片，利福平胶囊，吡嗪酰胺片），用药35天后出现皮疹，38天后出现发热、腹痛、皮疹加重。实验室检查：丙氨酸氨基转氨酶460 U/L，天冬氨酸氨基转氨酶533 U/L，γ-谷氨酰基转移酶80 U/L，胆碱酯酶3336 U/L。考虑为抗结核药导致的药物超敏反应综合征。停用所有抗结核药物，予支持对症治疗，患者腹痛逐渐缓解，仍反复发热，皮疹逐渐加重。后经保肝、激素冲击和免疫调节治疗后好转出院。
1例34歲女性肺結覈患者，予口服四聯抗結覈藥治療（異煙肼片，利福平膠囊，吡嗪酰胺片），用藥35天後齣現皮疹，38天後齣現髮熱、腹痛、皮疹加重。實驗室檢查：丙氨痠氨基轉氨酶460 U/L，天鼕氨痠氨基轉氨酶533 U/L，γ-穀氨酰基轉移酶80 U/L，膽堿酯酶3336 U/L。攷慮為抗結覈藥導緻的藥物超敏反應綜閤徵。停用所有抗結覈藥物，予支持對癥治療，患者腹痛逐漸緩解，仍反複髮熱，皮疹逐漸加重。後經保肝、激素遲擊和免疫調節治療後好轉齣院。
1례34세녀성폐결핵환자，여구복사련항결핵약치료（이연정편，리복평효낭，필진선알편），용약35천후출현피진，38천후출현발열、복통、피진가중。실험실검사：병안산안기전안매460 U/L，천동안산안기전안매533 U/L，γ-곡안선기전이매80 U/L，담감지매3336 U/L。고필위항결핵약도치적약물초민반응종합정。정용소유항결핵약물，여지지대증치료，환자복통축점완해，잉반복발열，피진축점가중。후경보간、격소충격화면역조절치료후호전출원。
A 34-year-old female patient with pulmonary tuberculosis was given therapy with combined use of four antituberculosis drugs including isoniazid,rifampicin,pyrazinamide and ethambutol. About 35 days later the patient got skin rash and 38 days later she got fever and abdominal pain,and the rash got worse. Laboratory tests showed the following results: ALT 460 U/L,AST 533 U/L,GGT 80 U/L and CHE 3 336 U/L. It was considered as hypersensitivity syndrome induced by antituberculosis drugs. After discontinuation of the antituberculosis drugs and symptomatic treatment was given, the patient's abdominal pain gradually relieved,but recurrent fever remained and rash aggravated. The patient recovered after the supportive liver protection therapy,glucocorticoid pulse therapy and immunoregulation were given.
