紫杉醇注射液致严重迟发型过敏反应1例.pdfVIP

中国药物应用与监测 2015 年10月第12卷第5 期 Chinese Journal of Drug Application and Monitoring, Vol.12, No.5, October 2015 紫杉醇注射液致严重迟发型过敏反应1 例 赵继红，侯东东，马丽萍，沈司京（北京大学首钢医院药剂科，北京100144 ） [摘要] 1例57 岁女性患者，因肺癌伴右颈淋巴结增大和颜面浮肿入院治疗。给予地塞米松预处理后，静脉滴注紫杉醇30 mg 化疗，患者无明显不适。之后给予紫杉醇90 mg ，ivgtt ，qd ，用药17 h后，患者出现恶心，胸背部瘙痒，前胸散在粟粒样浅红 色斑疹。给予苯海拉明（20 mg ，im ）、西替利嗪（10 mg ）和外擦炉甘石洗剂抗过敏治疗，皮疹未见好转，逐渐蔓延至全身。将 抗过敏治疗方案调整为氯苯那敏（4 mg ）、苯海拉明（20 mg ，im ）和氢化可的松琥珀酸钠（400 mg ，ivgtt ）等进行综合治疗，患 者皮疹逐渐好转，18 d后患者皮疹消退。 [关键词] 紫杉醇；迟发型过敏反应；皮疹；药品不良反应 [ 中图分类号] R969.3 [ 文献标识码] B [ 文章编号] 1672 - 8157(2015)05 - 0321 - 03 One case of serious delayed hypersensitivity reaction induced by paclitaxel for injection ZHAO Ji-hong, HOU Dong-dong, MA Li-ping, SHEN Si-jing(Department of Pharmacy, Peking University Shougang Hospital, Beijing 100144, China) [ABSTRACT] One 57-year-old female lung cancer patient with lymph node enlargement and facial edema was admitted to hospital. After pretreatment of dexamethasone, paclitaxel (30 mg, ivgtt, st) was given to her and then paclitaxel (90 mg, ivgtt, qd) followed. Seventeen hours later, the patient developed chest and back itching, nausea and scattered miliary plum macula in prothorax. The rash spreaded all over the body even after the antianaphylactic treatment with diphenhydramine (20 mg, im), cetirizine (10 mg) and calamine lotion. And then chlorpheniramine (4 mg), diphenhydramine (20 mg, im) and hydrocortisone sodium succinate (400 mg, ivgtt) were given to her. The patient was getting better gradually and the rash disappeared 18 days later. [KEY WORDS] Paclitaxel; Delayed hypersensitivity reaction; Rash; Adverse drug reaction 1 临床资料 射液）和苯海拉明（20 mg ，im ）预处理，于10 ：02 给 患者，女性，57 岁，2014 年11 月21 日因“确诊 予紫杉醇注射液（30 mg ，辰欣药业股份有限公司，批 肺癌1年余，右颈淋巴结进行性增大2 个月余，颜面 号1311291221 ） + 0.9% 氯化钠注射液（100 mL，qd ， 浮肿1个月”入肿瘤内科治疗。查体：T 36.5 ℃，P 76 ivgtt, 20 滴·min-1