紫杉醇诱发过敏性休克及室性心动过速  

Anaphylactic shock and ventricular tachycardia induced by paclitaxel

作　　者：张萍[1] 刘宏博[1] 陈愉[1] 谷秀[1] 肇丽梅[2] 赵立[1] 

机构地区：[1]中国医科大学附属盛京医院呼吸科,沈阳110004 [2]中国医科大学附属盛京医院药学部

出　　处：《药物不良反应杂志》2016年第2期147-148,共2页Adverse Drug Reactions Journal

摘　　要：1例59岁男性患者右肺腺癌术后行TP方案（紫杉醇＋顺铂）化疗，静脉滴注紫杉醇约90min时突发呼吸困难、心慌、皮肤潮红，血压降至70／40mmHg（1mmHg=0．133kPa）。立即予地塞米松10mg静脉注射，20min未缓解。予甲泼尼龙40mg静脉注射，同时予多巴胺升压，10min后患者症状稍缓解，但诉持续心慌。床旁心电图示室性心动过速，心室率1447次／min，予利多卡因50mg静脉注射。10min后患者心慌、呼吸困难缓解，心电图示心律转为窦性心动过速。继续给予吸氧、脱敏等对症治疗。共住院11d，患者未再发生心律失常，病情平稳出院。A 59-year-old male patient with right lung adenocarcinoma received chemotherapy with TP scheme （paelitaxel and cisplatin）. Ninety minutes after the start of IV infusion of paclitaxel, the patient suddenly developed dyspnea, palpitation, skin flushing, and his blood pressure decreased to 70/40 mmHg （1 mmHg =0. 133 kPa）. Dexamethasone 10 mg was given by an intravenous injection and 20 minutes later, his symptoms were still not improved. Then, an IV injection of methylprednisolone 40 mg and an IV infusion of dopamine were given. Ten minutes later, his symptoms partly relieved, but he still had palpitation. Beside electrocardiogram showed ventricular tachycardia with ventricular rate of 144 beats/min. Lidocaine 50 mg was given by an IV injection and 10 minutes later, his palpitation and dyspnea were improved, his heart rhythm was converted to sinus tachyeardia. Oxygen inhalation and desensitization therapies were given. The patient was treated for 11 days and discharged with stable condition. No arrhythmia recurred in the patient.

关 键 词：紫杉酚 过敏反应 心动过速 室性 

分 类 号：R979.1[医药卫生—药品]