| 钟晗,潘珏,陈璋璋.利福平致药物热1例报告[J].安徽医药,2017,21(5):955-956. |
| 利福平致药物热1例报告 |
| Rifampicin induced drug fever:a case report |
| 投稿时间：2016-11-02 |
| DOI： |
| 中文关键词: 利福平 抗结核药 药物热 |
| 英文关键词: Rifampicin Anti-tuberculosis drugs Drug fever |
| 基金项目:上海交通大学医学院医院药学科研基金青年项目(JDYX2016QN004) |
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| 中文摘要: |
| 目的 认识利福平导致的药物热的临床特征,提高对该不良反应的认识。方法 回顾分析1例服用利福平导致药物热病人的临床资料及药物治疗情况。结果 1例57岁女性病人因结核性胸腔积液给予异烟肼0.3 g,1 d 1次,口服,利福平0.45 g,1 d 1次,口服,乙胺丁醇0.75 g,1 d 1次,口服,吡嗪酰胺0.5 g,1 d 3次,口服,四联抗结核方案。用药15 d后,病人无明显诱因下出现畏寒发热,体温39~40.3 ℃,伴腹泻4次/天,恶心、呕吐、头晕。停用利福平、乙胺丁醇、吡嗪酰胺1 d后,体温恢复至正常,体温37.4 ℃。再次加用利福平、乙胺丁醇、吡嗪酰胺,病人再次发热,体温39 ℃。考虑抗结核药导致的药物热,遂停用所有抗感染药物,病人体温平。第2次停药5 d后,根据药物热发生率从小到大依次加用阿米卡星、乙胺丁醇、异烟肼、吡嗪酰胺、左氧氟沙星,在加药的过程中和加药后,病人体温维持在36.8~37.4 ℃。结论 病人的药物热很可能与利福平的使用相关。 |
| 英文摘要: |
| Objective To study the clinical features of rifampicin (RFP) induced drug fever and to improve the awareness of this adverse drug reaction.Methods The clinical data and medication therapy of 1 case of drug fever were retrospectively analyzed.Results A 57-year-old female with tuberculous pleural effusion received anti-tuberculosis (TB) treatment with isoniazid (INH),RFP,ethambutol (EMB)and pyrazinamide (PZA).After 15 days of anti-TB treatment,the patient presented symptoms with chills and fever,as well as diarrhea 4 times per day,nausea,vomiting and dizziness.After discontinuing the anti-TB drugs (RFP,EMB,PZA),the patient′s symptoms improved.With RFP,EMB,PZA rechallenge,the patient presented fever again.Taking into account the possibility of drug fever,all anti-infection drugs were discontinued.Then the patient′s temperature recovered.After anti-infection drugs withdrawal 5 days later,amikacin,EMB,INH,PZA,levofloxacin were administered sequentially according to the incidence of drug fever.So far,no fever was observed again.Conclusion The patient′s drug fever is likely to be associated with the use of rifampicin. |
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