西妥昔单抗疑致严重低镁血症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 西妥昔单抗疑致严重低镁血症1 例 1 2 （1.解放军总医院国宾一科，北京 100853 ；2. 解放军总医院肿瘤内一科，北京 100853 ） 祁春艳 ，齐晓光 [摘要] 1例42 岁男性患者，因确诊直肠癌多发转移1 个月余入院，既往体健；入院给予西妥昔单抗注射液（700 mg ，ivgtt ， d1 ；500 mg ，ivgtt ，d8、d15 ）；伊立替康注射液（120 mg，ivgtt ，d1、d5 ）；氟尿嘧啶注射液（750 mg ，滴斗入，d1 ；3500 mg ，持续 泵入48 h ，d1-2 ）；亚叶酸钙注射液（300 mg ，ivgtt ，d1 ）。治疗后19 d 出现严重低镁血症，监测期间血镁最低为0.12 mmol·L-1 （正常参考范围：0.7 ~ 1.2 mmol·L-1 ），结合各药物不良反应特点，考虑患者出现低镁血症很可能与西妥昔单抗有关，给予大剂 量补镁（硫酸镁注射液，补镁约4 ~ 6 g·d-1 ，ivgtt ）等对症治疗，治疗13 d后患者血镁恢复正常。 [关键词] 西妥昔单抗；低镁血症；药品不良反应 [ 中图分类号] R979.1 [ 文献标识码] B [ 文章编号] 1672 – 8157(2015)02 – 0131 – 02 One case of severe hypomagnesemia induced by cetuximab 1 2 QI Chun-yan , QI Xiao-guang (1. Department of Special Wards, PLA General Hospital, Beijing 100853, China; 2. Medical Oncology Department of PLA General Hospital, Beijing 100853, China Ⅰ ) [ABSTRACT] One 42-year-old male patient diagnosed as advanced metastasis of rectal cancer for 1 month was admitted. After admission, he received cetuximab injection (700 mg, ivgtt, d1; 500 mg, ivgtt, d8, d15); irinotecan injection (120 mg, ivgtt, d1, d5); fluorouracil injection (750 mg, d1; 3500 mg pumped for 48 h, d1-2); calcium folinate injection (300 mg, ivgtt, d1). Severe hypomagnesaemia happened on the 19th day after treatment. The lowest serum magnesium during the treatment was 0.12 mmol L-1 · -1 (normal reference range: 0.7 – 1.2 mmol L ). Considering the characteristics of each drug related adverse reaction, we inferred the · hypomagnesemia may be associated with the use of cetuximab. After the treatment of large dos