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药物变态反应可引起心脏损伤,我们曾遇到3例,现报告如下:例1.男,47岁,因急性扁桃体炎,肌注青霉素80万单位(皮试阴性),约5min后,感头晕、恶心,且出现大小便失禁.体检:神智恍惚,面色苍白,无皮疹;血压测不到,心率116次/min,律齐,心音低钝,肺呼吸音粗糙;腹部无异常.血Hbll2g/L,WBC23×10~9/L,N90%,L10%.心电图:窦性心动过速,Ⅰ Ⅱ V_2、V_4、V_5的S—T段向下偏移,V_3的T波及V_4和V_5的T波倒置.给予肾上腺素0.5mg加 50%葡萄糖液 20ml静注后,血压升至 16/8KPa;给予氢化可的松 300mg多巴胺 60 mg和间羟胺 20mg加10%葡萄糖液500ml静滴,以维持血压.翌日复查心电图恢复正常.
Drug allergy can cause heart damage, we have encountered in 3 cases, are as follows: Example 1. Male, 47 years old, due to acute tonsillitis, intramuscular injection of penicillin 800,000 units (skin test negative), about 5min, dizziness , Nausea, and incontinence. Physical examination: trance, pale, no rash; blood pressure can not be measured, the heart rate 116 beats / min, law Qi, low heart sound blunt, lung breath sounds rough; abdomen no abnormal blood Hbll2g / L, WBC23 × 10 ~ 9 / L, N90%, L10% .Electrocardiogram: sinus tachycardia, Ⅰ Ⅱ V_2, V_4, V_5 S-T segment downward bias, V_3 T wave V_4 and V_5 T Wave inversion. Give epinephrine 0.5mg plus 50% glucose solution 20ml intravenous injection, the blood pressure rose to 16 / 8KPa; give hydrocortisone 300mg dopamine 60mg and 20mg hydroxylamine 10% glucose solution 500ml intravenous infusion to maintain blood pressure The next day the electrocardiogram returned to normal.