二氮嗪胶囊致婴幼儿踝关节水肿及血乳酸升高1例分析  

Infant ankle edema and lactic acid increase induced by diazoxide:a case study

作　　者：杨佳 李根 江永贤 陶婉君 陈文文 梁华 YANG Jia;LI Gen;JIANG Yongxian;TAO Wanjun;CHEN Wenwen;LIANG Hua(Chengdu Women and Children's Central Hospital,School of Medicine,University of Electronic Science and Technology of China,Chengdu Sichuan 611731,China)

机构地区：[1]电子科技大学医学院附属妇女儿童医院,成都市妇女儿童中心医院药学部,四川成都611731

出　　处：《中国药物警戒》2022年第7期789-791,共3页Chinese Journal of Pharmacovigilance

摘　　要：目的 研究二氮嗪治疗婴幼儿先天性高胰岛素血症的安全性。方法 观察1例先天性高胰岛素血症伴脑损伤的1月龄男婴,使用二氮嗪过程中出现尿量减少、双踝关节水肿伴血乳酸升高。在住院期间对症给予利尿剂治疗以改善患儿双踝关节水肿,并动态监测患儿血乳酸。结果 出院后门诊随访患儿4个月,期间未再出现踝关节水肿或其他水钠潴留现象,定期复查血乳酸均未超过4.0 mmol·L-1。患儿停用二氮嗪治疗后,血糖稳定,复查血乳酸2.0 mmol·L-1,恢复正常。结论 小月龄婴幼儿使用二氮嗪时建议预防性使用噻嗪类利尿剂避免水钠潴留。在使用二氮嗪过程中应注意监测血乳酸,如果血乳酸增高建议动态监控并根据情况及时调整剂量,但对于乳酸重度升高且伴血气异常,代谢性酸中毒患儿,建议暂停二氮嗪治疗方案。Objective To study the safety of diazoxide in the treatment of congenital hyperinsulinemia in infants.Methods A one-month-old baby with congenital hyperinsulinemia and brain injury treated with diazoxide was observed.The decrease in the urine volume and edema of both ankles as well as the increase in blood lactic acid were recorded.Diuretics were given to the patient to mitigate the edema of ankle joints and blood lactic acid was monitored dynamically.Results After discharge,the patient was followed up for 4 months by the outpatient department,during which time no ankle edema or water and sodium retention occurred,and blood lactic acid never exceeded 4.0 mmol·L-1 after regular review.After the discontinuation of diazepine treatment,the blood glucose of the patient remained stable,and blood lactic acid returned to 2.0 mmol·L-1.Conclusion It is recommended that thiazide diuretics be used to prevent water and sodium retention while monitoring blood lactic acid when diazoxide is used.In case of the increase of blood lactic acid,dynamic and timely monitoring is recommended so as to adjust the dose as required.However,for children with a severe lactic acid increase accompanied by blood gas abnormality and metabolic acidosis,the treatment with diazoxide should be suspended.

关 键 词：高胰岛素血症 二氮嗪 药品不良反应 水钠潴留 乳酸升高 

分 类 号：R972[医药卫生—药品]