环孢素A联合地尔硫卓引起嘴唇水肿、呕吐1例.pdfVIP

中国药物应用与监测 2015 年4 月第12卷第2 期 Chinese Journal of Drug Application and Monitoring, Vol.12, No.2, April 2015 ·案例分析 · 环孢素A 联合地尔硫卓引起嘴唇水肿、呕吐1 例 1 1 1 2（1.武警广东省总队医院药剂科，广东 广州 510507; 2. 孙逸仙纪念医院药剂科，广东 广州 510120 ） 廖敏辉 ，李 平 ，刘永刚 ，李剑芳 [摘要]　1例15 岁男性患者因反复浮肿伴皮疹住院，既往有狼疮肾炎2 年余。入院前使用激素和吗替麦考酚酯治疗，狼疮肾 炎控制效果不佳，不良反应明显。入院后停用激素，改用环孢素联合地尔硫卓治疗，患者出现嘴唇水肿、呕吐、发热等不良 反应。停用两药后对症治疗，明显好转，5 d 后恢复正常，1周后给予他克莫司胶囊未出现类似症状。 [关键词]　环孢素A ；地尔硫卓；狼疮肾炎；嘴唇水肿；呕吐 [ 中图分类号]　R969.3　　 [ 文献标识码]　B　 [ 文章编号]　1672 – 8157(2015)02 – 0127 – 02 One case of lip edema and vomiting caused by cyclosporine A combination with diltiazem 1 1 1 2 LIAO Min-hui , LI Ping , LIU Yong-gang , LI Jian-fang (1. Department of Pharmacy, Guangdong Armed Police Corps Hospital, Guangzhou 510507, China; 2. Department of Pharmacy, Sun Yat-sen Memorial Hospital, Guangzhou 510120, China) [ABSTRACT]　One 15-year-old male patient with recurrent rash and swelling was admitted in hospital, with a history of lupus nephritis for more than 2 years. Glucocorticoids and mycophenolate mofetil were given before admission, lupus nephritis was not controlled well and adverse reactions happened. Steroid was replaced by cyclosporine and diltiazem after admission. Lip edema, vomiting and fever appeared and these two drugs were discontinued. The symptom significantly improved after symptomatic treatment. Five days later, situation returned to normal. A week later, tacrolimus capsules were administrated and no similar symptoms occurred. [KEY WORDS]　Cyclosporine A; Diltiazem; Lupus nephritis; Lip edema; Vomiting 1　临床资料 （100 mg ）和盐酸地尔硫卓片（30 mg ），11月20 日早 患者，男性，15岁，因“反复浮肿伴皮疹2 年”于 上7 点晨起时发现双唇浮肿，无疼痛、破溃、异常分 2013 年11月14 日住院。入院诊断：系统性红斑狼疮； 泌物，呕吐胃内容物4 次，T 37.5 ℃，血常规示：WBC 9 -1 狼疮肾炎；肾性高血压；癫痫？该患者于2011 年诊断