头孢哌酮钠舒巴坦钠致药物溶血性贫血的分析  

A Case Report of Cefoperazone-Sulbactam Sodium-induced Hemolytic Anemia

作　　者：马春娅[1] 张晓娟[1] 罗圆圆[1] 付丽辉[1] 何春宇 于洋[1] 汪德清[1] MA Chunya;ZHANG Xiaojuan;LUO LUO Yuanyuan(Blood Transfusion Department,the PLA General Hospital,Beijin g 100853)

机构地区：[1]中国人民解放军总医院输血科,北京100853

出　　处：《临床输血与检验》2018年第1期10-12,共3页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的建立针对药物溶血性贫血的诊断流程。方法应用卡式抗人球蛋白法完成患者红细胞直接抗人球蛋白试验(DAT)及DAT分型检测,应用药物致敏红细胞方法检测患者血浆内的药物抗体,分析患者的溶血及凝血指标。结果患者DAT阳性,分型为IgG+C3型,血浆内存在针对头孢菌素类药物抗体;患者用药后Hb从122 g/L下降至80 g/L,PLT从90×10~9/L下降至17×10~9/L;LDH从用药前189.5μmol/L上升至347.2μmol/L,AST从25.7 U/L上升至63.5 U/L;患者用药后PT从用药前的13.4 s延长到20.9 s,APTT从35.8 s最长延长到56.6 s,INR从1.19延长到1.8。结论患者因使用头孢哌酮钠舒巴坦钠发生针对血液系统的不良反应,导致药物溶血性贫血。Objective To report one case of hemolytic anemiainducedby cefoperazone-sulbactam sodium,with theestablishment of diagnostic procedure for the patient.M e t h o d s The anti-human globulin test and DAT typing of erythrocytes were performed in the patient.The antibodies against the drugs weredetected by drug-sensitized erythrocytes and the hemolytic and coagulation index were analyzed.Results DAT was positive and DAT typingshowed IgG+C3,and antibodies against cephalosporins was present in theserumof the patient,the Hb decreased from 122g/L to 80g/L after treatment and the PLT from 90×109/L to 17×109/L.Inversely,LDH increased from 189.5μmol/L to 347.2μmol/L and AST increased from 25.7 U/L to 63.5 U/L.PT prolonged from 13.4 s to 20.9 s and APTT from 35.8 s to 56.6 s,with the INR extending from 1.19 to 1.8.Conclusion Hemolytic anemiamay occurin the patient following cefoperazone-sulbactam sodium administration.

关 键 词：头孢哌酮钠舒巴坦钠 溶血性贫血 抗人球蛋白试验 药物抗体 

分 类 号：R978.11[医药卫生—药品] R446.11[医药卫生—药学]