1例利福平所致甲状腺功能异常的病例分析  

Analysis on Reasons of Thyroid Dysfunction Patient Caused by Rifampicin

作　　者：潘晓莉 史晓凤 王方[2] PAN Xiao-li;SHI Xiao-feng;WANG Fang(Clinical Medical School,Gansu University of Traditional Chinese Medicine,Lanzhou 730050,China;Infectious Department,Lanzhou General Hospital.Lanzhou Military Area Command,Lanzhou 730050,China)

机构地区：[1]甘肃中医药大学临床医学院,兰州730050 [2]兰州军区兰州总医院传染结核科,兰州730050

出　　处：《抗感染药学》2018年第6期1008-1010,共3页Anti-infection Pharmacy

摘　　要：目的:分析利福平所致甲状腺功能异常的布鲁菌病的发病特征。方法:布鲁菌病是一种人畜共患病,发病存在一定的地域性,多位于我国畜牧业较为发达的地区,近年来城市发病率呈上升趋势;布鲁菌病的发生、发展较为复杂,临床表现不一,一般表现为长期发热、多汗、关节痛、肝脾肿大等,严重危害人们的健康。结果与结论:布鲁菌是一种胞内寄生菌,首选一线治疗方案为多西环素+利福平;而利福平具有良好的抗菌作用但其不良反应也不容忽视,临床治疗发现1例利福平引起促甲状腺激素(TSH)异常的病例,考虑可能与利福平作为肝酶诱导剂可加速血清T3、T4的代谢率和外周清除率,反馈性引起TSH升高有关。Objective： To analyze the characteristics of Brucellosis of thyroid dysfunction patient caused by rifampicin. Methods： Brucellosis is a zoonotic disease, which is mostly located in the developed area of animal husbandry in China. In recent years, the incidence of brucellosis has increased year by year. The development of brucellosis is more complicated and the clinical manifestation is different. The common manifestations of the chronic dissease include fever, sweating, joint pain, hepatosplenomegaly, etc., which is seriously harmful to one＇s health. Results and Conclusion：Doxycycline rifampicin or streptomycin was regarded as the preferred first-line treatment, since Brucella is a kind of intracellular parasitic bacteria. It was found that rifampicin had a good antibacterial effect but its adverse reactions could not be ignored either. A case of rifampicin induced TSH abnormality has been recently found in our hospital. The results have been suggested that rifampicin as a hepatase inducer could accelerate the metabolism rate and peripheral clearance rate of serum T3, T4, and also could cause the increase of TSH by feedback.

关 键 词：利福平 布鲁菌病 促甲状腺激素 肝酶诱导剂 

分 类 号：R969.3[医药卫生—药理学]