阿糖胞苷致非心源性肺水肿  

Cytarabine-induced non-cardiogenic pulmonary edema

作　　者：杜虎[1] 陈晓东[1] 胡晓[2] 黄文祺[1] Du Hu;Chen Xiaodong;Hu Xiao;Huang Wenqi(Department of Intensive Care Medicine,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;Department of Hematology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学附属第二医院重症医学科,重庆400010 [2]重庆医科大学附属第二医院血液内科,重庆400010

出　　处：《药物不良反应杂志》2024年第3期186-188,共3页Adverse Drug Reactions Journal

摘　　要：1例30岁女性急性髓系白血病患者接受阿糖胞苷(200 mg/m2静脉滴注、1次/d,共7 d)联合伊达比星(10 mg/m2静脉滴注、1次/d,共3 d)方案(IA方案)化疗。治疗第5天,患者出现呼吸困难,呼吸35次/min,指脉血氧饱和度92%。给予高流量吸氧等治疗,当日夜间患者呼吸困难加重,心率160次/min,呼吸50次/min,指脉血氧饱和度50%;次日胸部CT示双肺肺泡性肺水肿合并间质性肺水肿。考虑为阿糖胞苷所致非心源性肺水肿。停用化疗药物,给予糖皮质激素、利尿、肺保护性通气、俯卧位通气等治疗,但患者相关症状未改善,10 d后出现继发性气胸并因呼吸衰竭死亡。A 30⁃year⁃old female patient with acute myeloid leukemia received chemotherapy with IA regimen of cytarabine(200 mg/m2 once daily by IV infusion,7 days in total)and idarubicin(10 mg/m2 once daily by IV infusion,3 days in total).On the 5th day of treatments,the patient developed dyspnea,with breath rate 35 times/min and finger pulse oxygen saturation 92%.She was treated with high flow oxygen inhalation,but the patient′s dyspnea was aggravated at night,with heart rate 160 times/min and breath rate 50 times/min;the finger pulse oxygen saturation decreased to 50%.Lung CT examination next day showed bilateral alveolar pulmonary edema with interstitial pulmonary edema,which was considered as non⁃cardiogenic pulmonary edema caused by cytarabine.Chemotherapy drugs were stopped and glucocorticoids,diuresis,lung protective ventilation,prone position ventilation,and other treatments were given,but the patient′s relevant symptoms were not improved.Ten days later,the patient developed secondary pneumothorax and died due to respiratory failure.

关 键 词：白血病 髓样 阿糖胞苷 肺水肿 死亡 

分 类 号：R969[医药卫生—药理学]