沙格列汀致过敏性休克死亡  

Death from anaphylactic shock caused by saxagliptin

作　　者：金欣 王程程[1] 武立群 封茂燕 Jin Xin;Wang Chengcheng;Wu Liqun;Feng Maoyan(Department of Clinical Pharmacy,Qilu Hospital of Shandong University,Shandong Province,Qingdao 266035,China)

机构地区：[1]山东大学齐鲁医院药学部,青岛266035

出　　处：《药物不良反应杂志》2022年第2期103-105,共3页Adverse Drug Reactions Journal

摘　　要：1例60岁男性患者因支气管哮喘、慢性阻塞性肺疾病急性发作和肝功能异常给予溴己新、甲泼尼龙、多索茶碱、布地奈德、特布他林、异丙托溴铵和多烯磷脂酰胆碱,病情好转。治疗第4天,因餐后血糖明显升高停用甲泼尼龙,给予沙格列汀5 mg口服、1次/d。患者首次服用沙格列汀后未见异常,第2次口服该药后约5 min出现意识丧失、牙关紧闭、全身紫绀等过敏性休克症状,指脉氧饱和度0.54。考虑可能为沙格列汀所致。立即给予肾上腺素0.5 mg皮下注射,但患者血氧饱和度进行性下降。患者病情进行性加重,予以心肺复苏术、气管插管接球囊辅助通气、肾上腺素、阿托品、糖皮质激素等抢救约1 h,无效。约4 h后患者仍无自主呼吸,临床死亡。A 60‑year‑old male patient was treated with bromhexine,methylprednisolone,doxofylline,budesonide,terbutaline,ipratropium bromide,and polyene phosphatidylcholine due to bronchial asthma,acute onset of chronic obstructive pulmonary disease,and abnormal liver function.His condition was improved.On day 4 of treatment,methylprednisolone was stopped and saxagliptin was given orally 5 mg once daily due to obvious elevated blood glucose after meals.The patient showed no abnormalities after taking saxagliptin for the first time.But about 5 minutes after taking the drug for the second time,anaphylactic shock symptoms such as loss of consciousness,lockjaw,and cyanosis appeared.The pulse oxygen saturation was 0.54.It was considered to be caused by saxagliptin.Epinephrine 0.5 mg was immediately administered subcutaneously,but the patient's oxygen saturation decreased progressively.The patient’s condition became progressively worse,rescues such as cardiopulmonary resuscitation,endotracheal intubation via balloon assisted ventilation,epinephrine,atropine,and glucocorticoid were performed for about 1 hour,but it was ineffective.About 4 hours later,the patient still had no spontaneous breathing and was declared clinically dead.

关 键 词：过敏反应 休克 死亡 二肽基肽酶Ⅳ抑制剂 沙格列汀 

分 类 号：R969.3[医药卫生—药理学]