一例过敏性输血反应疑似诱发Kounis综合征引起心率骤降的病例及文献分析  

A Case Report and Literature Analysis of Allergic Blood Transfusion Reaction Suspected to Induce Kounis Syndrome and Cause Sudden Heart Rate Drop

作　　者：邵明[1] 孔永奎[1] 李慧娟 田爱华 田文亮[2] 周帅[3] 张青青 杨乾坤[1] SHAO Ming;KONG Yongkui;LI Huijuan;TIAN Aihua;TIAN Wenliang;ZHOU Shuai;ZHANG Qingqing;YANG Qiankun(Department of Blood Transfusion,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052;Department of Hematology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052;Department of cardiology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052;Department of Electrocardiography,Xihua County People's Hospital,Zhoukou 466600)

机构地区：[1]郑州大学第一附属医院输血科,河南郑州450052 [2]郑州大学第一附属医院血液内科,河南郑州450052 [3]郑州大学第一附属医院心内科,河南郑州450052 [4]西华县人民医院心电图室,河南周口466600

出　　处：《临床输血与检验》2025年第1期83-88,共6页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的探讨过敏性输血反应后发生Kounis综合征的可能性和诊治方法。方法对一例输血后发生严重输血反应的患者进行回顾性分析。结果患者输注含有血浆的血制品多次出现过敏等输血反应,表现为全身瘙痒、精神异常、意识模糊、偶有胸闷,给予抗过敏、糖皮质激素后好转;最严重一次表现为心率骤降,给予血管活性药物、糖皮质激素十余分钟后恢复,考虑为Kounis综合征。结论严重的过敏性输血反应合并心血管症状时,需鉴定是否为Kounis综合征并进行全面的心脏系统检查,确保患者得到及时的诊治。Objective To explore the possibility of Kounis syndrome and its diagnosis and treatment strategies following allergic transfusion reaction.Methods A retrospective analysis was done of a patient who developed a severe allergic reaction after receiving blood transfusion.Results The patient experienced multiple allergic reactions and other transfusion-related events after receiving blood products containing plasma,manifested as systemic itching,altered mental status,blurred consciousness,and occasional chest tightness.After treatment with antihistamines and glucocorticoids,the condition improved.The most severe manifestation was sudden drop in heart rate,which was managed with vasoactive drugs and glucocorticoids,resulting in recovery after more than ten minutes.This was diagnosed as Kounis syndrome.Conclusion In cases of severe allergic transfusion reactions accompanied by cardiovascular symptoms,it is crucial to consider Kounis syndrome and a comprehensive cardiac evaluation is warranted to ensure timely diagnosis and treatment.

关 键 词：过敏 输血反应 Kounis综合征 心率骤降 

分 类 号：R457[医药卫生—治疗学]