复方醋酸棉酚片致低钾血症和横纹肌溶解综合征1例报告  

Hypokalemia and rhabdomyolysis syndrome caused by compound gossypol acetate:a case report

作　　者：饶峰 蔡辉[1] 秦亚勤 李宗友[1] RAO Feng;CAI Hui;QIN Yaqin;LI Zongyou(Department of Neurology,Fuyang People’s Hospital,Fuyang,Anhui 236000,China)

机构地区：[1]阜阳市人民医院神经内科,安徽阜阳236000

出　　处：《安徽医药》2020年第11期2325-2328,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的提高临床医生对醋酸棉酚所致不良反应的认识。方法回顾分析阜阳市人民医院2019年2月收治的1例临床主要表现为低钾血症、横纹肌溶解的中年女性病人的临床资料:该病人入院时有四肢无力、浓茶样小便,既往有妇科疾病、慢性胃炎、睡眠障碍,平素服用“雷贝拉唑钠肠溶片、马来酸曲美布汀片、复方醋酸棉酚片、劳拉西泮片、氯硝西泮片”等药物,入院查体发现四肢肌力下降,辅助检查示血钾浓度明显偏低,谷氨酸氨基转氨酶、天冬氨酸氨基转氨酶、乳酸脱氢酶、肌酸激酶、肌酸激酶同工酶等明显升高,经查阅药品说明书及复习相关文献,考虑病人合并电解质代谢紊乱、横纹肌溶解等是由于常年口服复方醋酸棉酚片所致。结果经及时停用复方醋酸棉酚片,并予加用保肝、补钾、补液等治疗,病人症状好转,复查相关指标,血钾、肌酶谱水平逐渐恢复,预后良好。结论在口服醋酸棉酚治疗相关疾病时,临床医生应密切关注其可能的低钾血症和横纹肌溶解综合征,注意定期复查血清钾和心电图等,及时发现,及时治疗,避免严重后果。Objective To improve clinicians’understanding of side effects caused by gossypol acetate.Methods The clinical data of a middle-aged female patient with hypokalemia and rhabdomyolysis were analyzed retrospectively.The patient had weakness of limbs and strong tea-like urination when she came,suffered from gynecological diseases,chronic gastritis,sleep disorders,and receiving the treatment of rabeprazole sodium enteric-coated tablet,trimebutine maleate tablet,compound gossypol acetate tablet,lorazepam tablet,clonazepam tablet and so on.It was found that the muscle strength of extremities decreased,the concentration of serum potassium was significantly lower,the content of glutamic-pyruvic transaminase,glutamic oxaloacetic transaminase,lactic dehydrogenase,creatine kinase and creatine kinase isoenzyme all increased visibly.After consulting the drug instructions and reviewing relevant literature,we considered that this patient with disorder of metabolism electrolyte and rhabdomyolysis was affected by oral administration of compound gossypol acetate tablet.Results With compound gossypol acetate tablet stopped in time,and the patient treated with hepatic protectant,potassium and a large gush of fluid,her clinical manifestations had improved and reexamined blood indexes revealed that the levels of serum potassium and muscle zymogram gradually recovered,and the prognosis was good.Conclusion When using gossypol acetate,clinicians should pay extra attention to the state of patients,serum potassium and electrocardiogram should be regularly reexamined,and timely detection and treatment are necessary for avoiding severe adverse reactions.

关 键 词：药物相关性副作用和不良反应 棉酚 低钾血症 横纹肌溶解 

分 类 号：R685.5[医药卫生—骨科学] R589.4[医药卫生—外科学]