药物不良反应杂志
藥物不良反應雜誌
약물불량반응잡지
ADVERSE DRUG REACTIONS JOURNAL
2014年
5期
304-305
,共2页
张慧娟%郭庆寅%任献青%翟文生%丁樱
張慧娟%郭慶寅%任獻青%翟文生%丁櫻
장혜연%곽경인%임헌청%적문생%정앵
他克莫司%泼尼松%酮症酸中毒
他剋莫司%潑尼鬆%酮癥痠中毒
타극막사%발니송%동증산중독
Tacrolimus%Prednisone%Ketoacidosis
1例8岁男性患儿因特发性膜性肾病应用他克莫司(1.25 mg,1次/12 h)联合泼尼松(12.5 mg,隔日1次)口服治疗。5周后,患儿相继出现多饮、多尿、呕吐、嗜睡、脱水征。实验室检查:空腹葡萄糖22.4 mmol/L,动脉血酸碱度7.24,标准碳酸氢盐12 mmol/L,尿酮体(+++)。诊断为酮症酸中毒。停用他克莫司,给予静脉补液(2125 ml/d)及重组人胰岛素2.5 U/h持续静脉输注。10 h后血酸碱度7.40,空腹葡萄糖8.5 mmol/L,连续2次检测尿酮体均为阴性,改为三餐前皮下注射重组人胰岛素6.25 U。3周后,患儿空腹葡萄糖5.9 mmol/L。
1例8歲男性患兒因特髮性膜性腎病應用他剋莫司(1.25 mg,1次/12 h)聯閤潑尼鬆(12.5 mg,隔日1次)口服治療。5週後,患兒相繼齣現多飲、多尿、嘔吐、嗜睡、脫水徵。實驗室檢查:空腹葡萄糖22.4 mmol/L,動脈血痠堿度7.24,標準碳痠氫鹽12 mmol/L,尿酮體(+++)。診斷為酮癥痠中毒。停用他剋莫司,給予靜脈補液(2125 ml/d)及重組人胰島素2.5 U/h持續靜脈輸註。10 h後血痠堿度7.40,空腹葡萄糖8.5 mmol/L,連續2次檢測尿酮體均為陰性,改為三餐前皮下註射重組人胰島素6.25 U。3週後,患兒空腹葡萄糖5.9 mmol/L。
1례8세남성환인인특발성막성신병응용타극막사(1.25 mg,1차/12 h)연합발니송(12.5 mg,격일1차)구복치료。5주후,환인상계출현다음、다뇨、구토、기수、탈수정。실험실검사:공복포도당22.4 mmol/L,동맥혈산감도7.24,표준탄산경염12 mmol/L,뇨동체(+++)。진단위동증산중독。정용타극막사,급여정맥보액(2125 ml/d)급중조인이도소2.5 U/h지속정맥수주。10 h후혈산감도7.40,공복포도당8.5 mmol/L,련속2차검측뇨동체균위음성,개위삼찬전피하주사중조인이도소6.25 U。3주후,환인공복포도당5.9 mmol/L。
An 8-year-old boy received concomitant treatment with tacrolimus 1. 25 mg every 12 hours and prednisone 12. 5 mg once every other day for idiopathic membranous nephropathy. Five weeks later,the boy developed polydipsia,polyuria,vomiting,somnolence,and dehydration. Laboratory tests showed the following values:fasting plasma glucose 22. 4 mmol/L,blood pH 7. 24,standard bicarbonate 12 mmol/L,and urine ketone bodies( +++). The patient was diagnosed with ketoacidosis. Tacrolimus was stopped and he was treated with fluid supplementation 2 125 ml/d and continuous IV infusion of recombinant human insulin 2. 5 U/h. After 10 hours,laboratory results indicated that blood pH was 7. 40,fasting plasma glucose was 8. 5 mmol/L,and detection of urine ketone was negative for two times in a row. Then,his treatment was switched to subcutaneous injection of recombinant human insulin 6. 25 U before three meals. After 3 weeks,the fasting plasma glucose was 5. 9 mmol/L.