舒血宁注射液致过敏性休克和肝肾功能损伤  

Anaphylactic shock, liver and kidney injury caused by Shuxuening injection（舒血宁注射液）

作　　者：朱建新[1] 马丽萍[1] 赵继红[1] 沈司京[1] 

机构地区：[1]北京大学首钢医院药剂科,100144

出　　处：《药物不良反应杂志》2016年第1期74-75,共2页Adverse Drug Reactions Journal

摘　　要：1例66岁男性冠状动脉粥样硬化性心脏病患者白内障术后给予舒血宁注射液18 ml加入0.9%氯化钠注射液250 ml，1次/d静脉滴注。第2次给药约30 min时，患者突然出现寒战、全身疼痛、恶心和呕吐，体温40.2 ℃，心率110次/min，血压95/56 mmHg（1 mmHg=0.133 kPa）。实验室检查：ALT 116 U/L，AST 165 U/L，TBil 17.8 μmol/L，DBil 9.6 μmol/L，BUN 7.6 mmol/L，Scr 110 μmol/L。诊断：过敏性休克，肝损伤，肾损伤。立即停用舒血宁注射液，给予苯海拉明20 mg肌内注射，地塞米松5 mg静脉滴注，还原型谷胱甘肽1.2 g静脉滴注、1次/d，百令胶囊2 g口服、3次/d。2 d后，患者体温36.6 ℃，血压124/76 mmHg，心率69次/min。次日复查ALT 75 U/L，AST 37 U/L，TBil 8.4 μmol/L，DBil 3.0 μmol/L，BUN 4.8 mmol/L，Scr 73 μmol/L。A 66-year-old male patient with coronary atherosclerotic heart disease received an IV infusion of Shuxuening injection 18 ml＋0.9% sodium chloride injection 250 ml once daily after cataract surgery. About 30 minutes after the second infusion start, the patient suddenly experienced chill, whole body pain, nausea and vomiting. His body temperature was 40.2 ℃, heart rate was 110 beats/min, blood pressure was 95/56 mmHg. Laboratory test revealed the following levels： alanine aminotransferase 116 U/L, aspartate aminotransferase 165 U/L, total bilirubin 17.8 μmol/L, direct bilirubin 9.6 μmol/L, urea nitrogen 7.6 mmol/L, and creatinine 110 μmol/L. The patient was diagnosed as anaphylactic shock, liver and kidney injury. Shuxuening injection was stopped. He was treated with intramuscular injection of diphenhydramine 20 mg, IV infusions of dexamethasone 5 mg, IV infusion of glutathione 1.2 g once daily, oral Bailing capsule（百令胶囊） 2 g thrice daily. Two days later, his body temperature was 36.6 ℃, the blood pressure was 124/76 mmHg, and the heart rate was 69 beats/min. The following day, laboratory test showed the following values： alanine aminotransferase 75 U/L, the aspartate aminotransferase 37 U/L, the total bilirubin 8.4 μmol/L, the direct bilirubin 3.0 μmol/L, the urea nitrogen 4.8 mmol/L, and the creatinine 73 μmol/L.

关 键 词：过敏反应 药物性肝损伤 急性肾损伤 舒血宁 

分 类 号：R286[医药卫生—中药学]