摘要
1例67岁男性患者,因"进行性排尿困难伴双下肢麻木、无力5 d"入院,诊断为脊髓炎。既往体健,否认药物、食物过敏史。入院后给予大剂量注射用甲泼尼龙琥珀酸钠冲击治疗,后逐渐减量改为小剂量甲泼尼龙片口服。治疗第26天,患者出现腹痛、腹泻症状,查血淀粉酶升高(553 U·L^(-1)),腹部CT示胰腺略饱满,诊断为急性胰腺炎。排除原发疾病及其他用药等诱发因素,考虑急性胰腺炎为甲泼尼龙相关不良反应,遂停用甲泼尼龙片,同时给予注射用艾司奥美拉唑、奥曲肽注射液、注射用乌司他丁、复方氨基酸注射液、地塞米松注射液(5 mg,qd)等药物治疗胰腺炎。后因胰腺炎发展迅速,并发多器官功能衰竭,患者于第34天放弃治疗出院。
One 67-year-old male patient was admitted because of progressive dysuria,numbness and weakness of both lower extremities for 5 days,and was diagnosed with myelitis.This patient was well healthy before,and denied a history of allergies to drugs and food.A high-dose methylprednisolone pulse therapy was given in the initial treatment phase,and then gradually reduced to low-dose orally.After 26 days of treatment,some symptoms of abdominal pain,and diarrhea appeared on this patient,and then acute pancreatitis was diagnosed with a high level of serum amylase（553 U·L-1）and an abdominal CT showing a slightly plump pancreas.The acute pancreatitis was considered to the adverse drug reaction of methylprednisolone except other reasons of primary diseases and medicines.Then the methylprednisolone was stopped,and dexamethasone,esomeprazole,octreotide,ulinastatin,and aminoacid injections were given in the treatment of acute pancreatitis.In the subsequent treatment,the condition of pancreatitis took a turn for the worse rapidly with multiple organ failures.Finally,this patient gave up his treatment and discharged from hospital on the 34th day.
出处
《中国药物应用与监测》
CAS
2017年第6期381-384,共4页
Chinese Journal of Drug Application and Monitoring
基金
中国博士后科学基金项目(2015M582894)
关键词
糖皮质激素
甲泼尼龙
急性胰腺炎
药品不良反应
Glucocorticoid
Methylprednisolone
Acute pancreatitis
Adverse drug reaction
