注射用复方甘草酸苷致过敏性休克  

Anaphylactic shock caused by compound glycyrrhizin for injection

作　　者：王鑫璐 李月阳[1] 闫荟羽[1] 王相峰 Wang Xinlu;Li Yueyang;Yan Huiyu;Wang Xiangfeng(Department of Pharmacy, the First Hospital of Jilin University, Changchun 130021, China)

机构地区：[1]吉林大学第一医院药学部,长春130021

出　　处：《药物不良反应杂志》2019年第4期297-298,共2页Adverse Drug Reactions Journal

摘　　要：1例43岁女性患者因肝损伤给予注射用还原型谷胱甘肽(1.2 g入5%葡萄糖注射液100 ml)、多烯磷脂酰胆碱(697.5 mg入5%葡萄糖注射液250 ml)、注射用复方甘草酸苷(120 mg入5%葡萄糖注射液250 ml)静脉滴注,1次/d。首次静脉滴注注射用复方甘草酸苷约20 min(注射液入量约50 ml)时,患者突发皮疹、心悸、呼吸困难、全身大汗、腹痛、烦躁不安,心率126次/min,血压85/45 mmHg(1 mmHg=0.133 kPa)。考虑为注射用复方甘草酸苷引起的过敏性休克,立即停用注射用该药并静脉给予地塞米松、盐酸异丙嗪、葡萄糖酸钙、肾上腺素后,患者症状缓解。次日停用注射用复方甘草酸苷和注射用还原型谷胱甘肽,继续原剂量应用多烯磷脂酰胆碱,并给予乙酰半胱氨酸8 g入10%葡萄糖注射液250 ml静脉滴注、1次/d,双环醇片50 mg口服、3次/d,患者未再出现过敏反应。7 d后,患者肝功能明显改善。A 43-year-old female patient was given IV infusions of reduced glutathione for injection (1.2 g, added in 100 ml of 5% glucose injection), polyenephosphatidylcholine (697.5 mg, added in 250 ml of 5% glucose injection), and compound glycyrrhizin for injection (120 mg, added in 250 ml of 5% glucose injection) once daily for liver injury. After 20 minutes of the first infusion of compound glycyrrhizin for injection (the injection volume was about 50 ml), the patient developed skin rash, palpitations, dyspnea, drenching sweats, abdominal pain, and dysphoria. Meanwhile her heart rate was 126 beats/min and blood pressure was 85/45 mmHg. In consideration of anaphylactic shock caused by compound glycyrrhizin, the drug was immediately stopped and IV injections of dexamethasone, promethazine hydrochloride, and calcium gluconate were given. Then the patient′s symptoms relieved. Except for polyenephosphatidylcholine, the compound glycyrrhizin for injection and reduced glutathione for injection were discontinued the next day and IV infusion of acetylcysteine (8 g, added in 250 ml of 10% glucose injection) once daily and oral bicyclol tablets 50 mg thrice daily were given. The patient did not developed anaphylaxis again. Seven days later, the patient′s fatigue induced by liver injury obviously improved.

关 键 词：过敏反应 休克 复方甘草酸苷 

分 类 号：R969[医药卫生—药理学]