摘要
目的探讨伏立康唑治疗过程中发生的药物不良反应,提醒临床医师和药师对伏立康唑相关不良反应引起重视。方法报道1例侵袭性肺部真菌病的慢性阻塞性肺疾病患者,使用伏立康唑过程中出现急性胰腺炎,复习国内外报道的伏立康唑引起不良反应的相关文献资料,分析胰腺炎和伏立康唑关联情况。结果患者,女,74岁,有慢性阻塞性肺疾病基础,因"反复咳嗽、咳痰10余年,加重伴胸闷、气促5 d"入院。胸部CT提示:两肺多发感染,多次痰培养提示:曲霉菌阳性,考虑合并侵袭性肺曲霉病。使用伏立康唑胶囊后胸闷、咳嗽症状有所好转,但用药23 d后并发急性胰腺炎,停药并给予对症处理后患者症状缓解。结论本例中急性胰腺炎的发生被认为和使用伏立康唑有关。由于伏立康唑引起的急性胰腺炎罕见,临床医师需时刻密切关注伏立康唑的临床用药安全。
Objective To investigate the adverse effects of voriconazole during the course of treatment,and remind clinicians and pharmacists to pay attention to the adverse reactions of voriconazole.Methods A case of acute pancreatitis during the treatment of voriconazole in chronic obstructive pulmonary disease with invasive pulmonary aspergillosis was reported.The literatures about the side effects of voriconazole reported at home and abroad were reviewed to analyze the correlation between pancreatitis and voriconazole.Results A 74-year-old female with chronic obstructive pulmonary disease was admitted to the hospital with repeated coughs and expectorations for more than ten years and aggravation accompanied by chest stuffy breath for five days.Chest CT suggested multiple infections in both lungs,and multiple sputum cultures suggested positive aspergillosis,which were considered to be associated with invasive pulmonary aspergillosis.Chest tightness and cough symptoms were improved after the use of vriconazole capsules,but acute pancreatitis occurred after treatment for 23 days.The symptoms of patient were relieved after discontinuation of voriconazole and symptomatic treatment.Conclusions In this case,acute pancreatitis is considered to be associated with the use of voriconazole.Because acute pancreatitis caused by voriconazole is rare,clinicians should always pay close attention to the safety of clinical medication of voriconazole.
作者
徐欢
朱星星
唐从胜
潘志杰
Xu Huan;Zhu Xingxing;Tang Congsheng;Pan Zhijie(Department of Respiratory Medicine,Haining People′s Hospital,Haining 314400,China;Department of Respiratory Medicine,the First Affiliated Hospital,Zhejiang University,Hangzhou 310000,China)
出处
《国际呼吸杂志》
2019年第24期1881-1884,共4页
International Journal of Respiration
关键词
侵袭性肺曲霉病
伏立康唑
急性胰腺炎
不良反应
Invasive pulmonary aspergillosis
Voriconazole
Acute pancreatitis
Adverse reactions
