摘要
1 例70男性患者因肺炎给予头孢唑肟钠3 g加入0.9%氯化钠注射液250 ml静脉滴注，2次/d。首次给药后约20 min，患者突发腰痛、寒战、意识模糊。体格检查见皮肤巩膜中度黄染。实验室检查：外周血白细胞计数11×10^9/L，中性粒细胞0.8，红细胞计数3.2×10^12/L，血红蛋白91 g/L，网织红细胞计数0.081，总胆红素98 μmol/L，间接胆红素80 μmol/L，直接抗人球蛋白试验阳性；尿呈浓茶色，胆红素（＋），潜血（＋＋＋），红细胞0～2个/HP。考虑头孢唑肟钠致急性药物性溶血性贫血。给予水化及碱化尿液治疗。停用头孢唑肟钠，改用磷霉素抗感染。第5天复查，患者黄染消失、尿色恢复正常，白细胞计数4×10^9/L，红细胞计数4.2×10^12/L，血红蛋白131 g/L，网织红细胞计数0.015，总胆红素17 μmol/L，间接胆红素10 μmol/L；尿胆红素（-），潜血（-），红细胞0～1个/HP。
A 70-year-old man with pneumonia received an IV infusion of ceftizoxime sodium 3 g in 0.9% sodium chloride 250 ml twice daily. Twenty minutes after the first infusion, he developed low back pain, chills and confusion. He presented with moderately jaundiced skin and sclera. Laboratory tests revealed the following results： white blood cell （WBC） count 11×10^9/L, neutrophil 0.8, red blood cell （RBC） count 3.2×10^12/L, hemoglobin 91 g/L, reticulocytes 0.081, total bilirubin 98 μmol/L, indirect bilirubin 80 μmol/L. Direct Coomb＇s test（＋）. He developed strong tea-colored urine. Routine urine tests showed the following results： urine bilirubin （＋）, occult blood （＋＋＋）, 0-2 red cells per high power field. Ceftizoxime sodium-induced acute hemolytic anemia was considered. He received hydration and alkalizing of urine. Ceftizoxime sodium was switched to fosfomycin. On day 5, the jaundice disappeared and the color of urine returned to normal. Laboratory tests showed the following results： WBC count 4×10^9/L, RBC count 4.2×10^12/L, hemoglobin 131 g/L, reticulocytes 0.015, total bilirubin 17 μmol/L, indirect bilirubin 10 μmol/L, urine bilirubin （-）, occult blood （-）, 0-1 red cells per high power field.
出处
《药物不良反应杂志》
CSCD
2015年第5期383-384,共2页
Adverse Drug Reactions Journal
关键词
头孢唑肟
贫血
溶血性
Ceftizoxime
Anemia, hemolytic
