替比夫定片致呕吐伴肌酸激酶及乳酸升高1例分析  

Telbivudine induced vomiting with elevated creatine kinase and lactic acid:a case report

作　　者：梁凯 赖铭裕[1] LIANG Kai;LAI Mingyu(Department of Gastroenterology,the First Affiliated Hospital of Guangxi Medical University,Nanning Guangxi 530021,China)

机构地区：[1]广西医科大学第一附属医院消化内科,广西南宁530021

出　　处：《中国药物警戒》2022年第1期111-112,共2页Chinese Journal of Pharmacovigilance

基　　金：广西医疗卫生适宜技术开发与推广应用项目(S2019100)。

摘　　要：目的对替比夫定片致呕吐伴肌酸激酶及乳酸升高病例进行分析,为临床安全用药提供参考。方法分析1例替比夫定片致呕吐伴肌酸激酶及乳酸升高患者的诊疗经过,结合文献检索,探索替比夫定片诱发呕吐伴肌酸激酶及乳酸升高的机制及应对措施。结果患者在遵医嘱持续抗病毒治疗约5月后,出现反复呕吐,实验室查肌酸激酶1559 U·L^(-1),血乳酸8.930 mmol·L^(-1)。立即停用替比夫定片,改用恩替卡韦抗病毒,患者呕吐症状逐渐好转,肌酸激酶及血乳酸有下降趋势;停药2周后,无呕吐症状,肌酸激酶及血乳酸基本恢复正常。结论使用替比夫定片进行治疗时,需密切关注不良反应的发生,当出现呕吐、肌酸激酶升高及乳酸升高等情况时,应及时停药,更改抗病毒治疗方案。Objective To analyze a case of vomiting with elevated creatine kinase and lactic acid caused by tibivudine,so as to provide reference for clinical safe drug use.Methods The process of treating one case of vomiting with elevated creatine kinase and lactic acid caused by tibivudine was analyzed based on literature retrieval.Results The patient appeared recurrent vomiting,creatine kinase 1559 U·L^(-1) and blood lactic acid 8.930 mmol·L^(-1) after using tibivudine about 5 months.Stopped using tibivudine immediately and changed to entecavir.The patient was getting better.2 weeks after withdrawal,there were no vomiting symptoms,creatine kinase and blood lactic acid basically returned to normal.Conclusion We should pay close attention to the occurrence of adverse reactions when using tibivudine.Once vomiting,elevated creatine kinase and lactate increase occur,the drug should be stopped in time and changed the treatment plan.

关 键 词：替比夫定片 药品不良反应 呕吐 高乳酸血症 肌酸激酶升高 

分 类 号：R994.11[医药卫生—毒理学]