误服大剂量度洛西汀致小儿重度5-羟色胺综合征  

Severe serotonin syndrome caused by mistaken used of overdose of luoxetine in a child

作　　者：安静 周晓娜 An Jing;Zhou Xiaona(Department of Pediatric Intensive Care Unit,Xuchang Central Hospital,Henan Province,Xuchang 461000,China)

机构地区：[1]许昌市中心医院儿科重症监护室,许昌461000

出　　处：《药物不良反应杂志》2023年第10期633-634,共2页Adverse Drug Reactions Journal

摘　　要：1例5岁4个月男孩误服度洛西汀约1000 mg,30 min后陆续出现精神萎靡、呕吐、肌肉震颤、意识障碍、激越型谵妄、高热、心动过速、抽搐等症状,诊断为度洛西汀中毒所致重度5-羟色胺综合征,给予洗胃、导泄、血液灌流、赛庚啶、咪达唑仑、物理降温等治疗。12 h后实验室检查示肌酸激酶274 U/L,肌红蛋白247 mg/L,尿素氮9.5 mmol/L,尿酸452 U/L,血肌酐55μmol/L;36 h后复查,肌酸激酶674 U/L,尿素氮10.3 mmol/L,血尿酸350μmol/L,血肌酐70μmol/L,给予辅酶Q_(10)及维生素C等保护脏器功能治疗。8 d后上述症状消失,实验室检查示肌酸激酶149 U/L,肌红蛋白66 mg/L,尿素氮4.3 mmol/L,血尿酸75μmol/L,血肌酐34μmol/L。A 5‑year‑old and 4‑month‑old boy took duloxetine about 1000 mg mistakenly.After 30 minutes,symptoms such as listlessness,vomiting,muscle tremor,disturbance of consciousness,agitation delirium,high fever,tachycardia,convulsions etc.occurred successively.Severe serotonin syndrome caused by duloxetine poisoning was diagnosed and treatments such as gastric lavage,catharsis,hemoperfusion,cyproheptadine,midazolam,and physical cooling were given.Twelve hours later,laboratory tests showed creatine kinase 674 U/L,myoglobin 247 mg/L,blood urea nitrogen 9.5 mmol/L,uric acid 452μmol/L,serum creatinine 55μmol/L;36 hours later,the results were creatine kinase 674 U/L,blood urea nitrogen 10.3 mmol/L,uric acid 350μmol/L,and serum creatinine 70μmol/L.Coenzyme Q_(10)and vitamin C were given to protect organ function.Eight days later,the boy′s symptoms disappeared.Laboratory tests showed creatine kinase 149 U/L,myoglobin 66 mg/L,urea nitrogen 4.3 mmol/l,uric acid 75μmol/L,and serum creatinine 34μmol/L.

关 键 词：儿童 中毒 5-羟色胺综合征 度洛西汀 用药错误 

分 类 号：R725[医药卫生—儿科] R969[医药卫生—临床医学]