复方苯巴比妥溴化钠片、复方苯硝那敏片和九龙化风丸联用致超敏综合征  

Hypersensitivity syndrome due to concomitant use of phenobarbital and sodium bromide tablets,compound phenobarbital nitrazepam and chlorphenamine tablets,and Jiulonghuafeng pills

作　　者：徐丽君 

机构地区：[1]浙江省三门县人民医院药剂科,浙江三门317100

出　　处：《药物不良反应杂志》2011年第5期312-313,共2页Adverse Drug Reactions Journal

摘　　要：1例24岁男性癫痫患者长期口服丙戊酸钠疗效不佳。后改为口服复方苯巴比妥溴化钠1片,3次/d;复方苯硝那敏片午餐后2片,晚餐后1片;九龙化风丸4丸,3次/d。服药约1个半月后患者颜面、躯干、上肢等部位出现红色斑丘疹,后蔓延至全身,伴有口唇溃烂、高热、颜面部水肿、咳嗽咯痰。停用上述药物。实验室检查:丙氨酸转氨酶(ALT)742 U/L,天冬氨酸转氨酶(AST)279 U/L,碱性磷酸酶406 U/L,γ-L-谷氨酰转肽酶1123 U/L,C反应蛋白57.4 mg/L,肌酸激酶235 U/L,肌酸激酶同工酶60 U/L,α-羟丁酸脱氢酶561 U/L,乳酸脱氢酶899 U/L。诊断为抗癫痫药联用所致药物超敏综合征,给予甲泼尼龙静脉注射治疗。治疗6 d后,患者症状明显改善,复查肝功能:ALT 165 U/L,AST 55 U/L。入院第25天,患者痊愈出院。A 24-year-old male patient with epilepsy received long-term use of sodium vedproate with no obvious effect. The therapy was replaced with 1 tablet of phenobarbital and sodium bromide thrice daily, 2 tablets of compound phenobarbital nitrazepam and chlorphenamine after lunch and 1 tablet after supper, and 4 Jiulonghuafeng pills thrice daily. One and a half months later, he presented with red maculopapule on his facial, trunk, and upper limbs, which then spread to his entire body, accompanied by lip ulceration, high fever, facial edema, cough and expectoration. Above-mentioned drugs was discontinued. Laboratory tests revealed the following levels： ALT 742 U/L, AST 279 U/L, ALP 406 U/L, γ-GT 1123 U/L, CRP 57.4 mg/L, CK235 U/L, CK-MB 60 U/L, α-HBDH 561 U/L, LDH 899 U/L. Antiepileptic drug-induced hypersensitivity syndrome was diagnosed. The patient was given an IV infusion of methylprednisolone. After 6 days of treatment, his symptoms improved markedly, repeat liver function tests showed a ALT level of 165 U/L, a AST level of 55 U/L. On day 25 of admission, He recovered and was discharged.

关 键 词：抗癫痫药 复方苯巴比妥溴化钠片 复方苯硝那敏片 九龙化风丸 超敏综合征 

分 类 号：R595.3[医药卫生—内科学]