华法林致急性胰腺炎  

Acute pancreatitis induced by warfarin

作　　者：何彦侠[1] 薛兵[1] 赵淑敏[1] 

机构地区：[1]北京市垂杨柳医院呼吸内科,100022

出　　处：《药物不良反应杂志》2016年第2期154-155,共2页Adverse Drug Reactions Journal

摘　　要：1例56岁男性因急性肺栓塞给予华法林3mg／d口服，后根据INR调整剂量为4．5mg／d。华法林治疗第10天，患者出现上腹部剧烈疼痛，实验室检查示血清淀粉酶为360U／L。次日血清淀粉酶升至960U／L，腹部超声及CT示胰腺弥漫增大，胰腺周围轻度液性渗出，诊断为急性胰腺炎。停用华法林，给予奥美拉唑、生长抑素等治疗。10d后，患者腹痛缓解，血清淀粉酶降至130U／L。第15天，因患者下肢静脉曲张再次给予华法林3mg／d口服。1周后，患者再次出现上腹痛，血清淀粉酶256U／L。停用华法林后3d患者腹痛好转，1周后血清淀粉酶降至78U／L。A 56-year-old male patient received oral warfarin 3 mg once daily for acute pulmonary embolism. Warfarin was added to 4.5 mg once daily based on international normalized ratio. On day 10 after administration of warfarin, the patient presented severe epigastric pain. Laboratory tests showed that serum amylase level was 360 U/L and 960 U/L on the next day. Abdominal ultrasound examination and CT showed a diffusely enlarged pancreas and fluid exudation around pancreas. The patient was diagnosed as acute pancreatitis. Warfarin was withdrawn and somatostatin and omeprazole were given. His abdominal pain was relieved obviously and serum amylase decreased to 130 U/L on the lOth day after warfarin withdrawal. Fifteen days after warfarin withdrawal, warfarin 3 mg once daily was given again because of varicose vein of lower limb. One week later, the patient＇s abdominal pain appeared again and serum amylase elevated to 256 U/L. Warfarin was stopped again. Three days later, the patient＇s condition improved. After one week, his serum amylase returned to 78 U/L.

关 键 词：华法林 胰腺炎 

分 类 号：R576[医药卫生—消化系统]