达托霉素致横纹肌溶解1例  

A case of rhabdomyolysis caused by daptomycin

作　　者：孙继敏[1] 方会慧[1] 杨培培[1] SUN Ji-min;FANG Hui-hui;YANG Pei-pei(Department of Pharmacy,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院药剂科,安徽合肥230022

出　　处：《中国药物应用与监测》2023年第2期143-146,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：1例72岁男性患者,因“间断发热1周余”入院,既往长期口服瑞舒伐他汀片(5 mg,qd),入院诊断为“肺部感染”,予以抗感染治疗后好转。住院期间,患者再次发热,考虑导管相关性感染不除外,给予达托霉素(0.5 g,qd,ivgtt)治疗。用药第14 d,患者肌酸激酶(CK)588 IU·L^(−1)、肌酸激酶同工酶(CK-MB)35.40 ng·mL^(−1),血清肌红蛋白281.30 ng·mL^(−1),尿肌红蛋白2.30 ng·mL^(−1),临床诊断为横纹肌溶解,立即停用达托霉素和瑞舒伐他汀,并予以补液和碱化尿液对症治疗。3 d后复查,CK 87 IU·L^(−1),CK-MB 2.70 ng·mL^(−1),血清肌红蛋白87.30 ng·mL^(−1),尿中未再检测到肌红蛋白。1周后恢复瑞舒伐他汀使用,未再出现CK升高,患者病情稳定出院。A 72-year-old male patient was admitted to hospital due to intermittent fever for more than a week.He was diagnosed with pulmonary infection and improved after anti-infection treatment.He regularly took rosuvastatin(5 mg,qd)for a long time.During hospitalization,daptomycin(0.5 g,qd,ivgtt)was given to him due to fever again and suspected catheter-related infection.14 days after administration,results of the lab test showed that serum creatine kinase(CK)was 588 IU·L^(−1),CK-MB was 35.40 ng·mL^(−1),serum myoglobin was 281.30 ng·mL^(−1),and urine myoglobin was 2.30 ng·mL^(−1),which was diagnosed with rhabdomyolysis.Daptomycin and rosuvastatin were discontinued immediately,and fluid rehydration therapy as well as alkalinity urine therapy were given to him.Three days later,results of repeated lab test showed that CK was 87 IU·L^(−1),CK-MB was 2.70 ng·mL^(−1),serum myoglobin was 87.30 ng·mL^(−1),and no further myoglobin was detected in the urine.Rosuvastatin was resumed a week later and no elevated CK was found again.The patient was discharged in a stable condition.

关 键 词：达托霉素 肌酸激酶 横纹肌溶解 瑞舒伐他汀 药品不良反应 

分 类 号：R969.3[医药卫生—药理学] R978.1[医药卫生—药学]