摘要
1例72岁男性患者,因心房颤动入院。住院期间出现短阵室性心动过速,给予胺碘酮片治疗[0.2 g,口服(po),每日三次(TID)],后因快速房颤,加用胺碘酮注射液治疗(首剂150 mg,缓慢静脉注射;之后在16 h 20 min内持续静脉泵入520 mg),1天内出现肝功能衰竭[丙氨酸氨基转移酶(ALT)1821 U/L,天门冬氨酸转移酶(AST) 2260.7 U/L,血糖(Glu) 1.11 mmol/L]、急性肾衰竭[尿素(UREA) 12.18 mmol/L,肌酐(CREA) 163.9 umol/L]、弥散性血管内凝血。停用胺碘酮,加用保肝、血液净化等综合治疗,患者肝功、肾功、凝血功能逐渐恢复。考虑急性肾衰竭、DIC为肝衰竭所致,故采用RUCAM因果关系评估量表,得分为6分,表示急性肝功能衰竭与胺碘酮之间相关性为很可能。
A 72-year-old male patient was admitted to the hospital with atrial fibrillation. During his hospital-ization, he developed short-onset ventricular tachycardia and was treated with amiodarone tablets [0.2 g orally (po) three times daily (TID)], followed by amiodarone injection (first dose 150 mg, slow intravenous infusion;followed by continuous intravenous pumping of 520 mg over 16 h 20 min) due to rapid atrial fibrillation, and developed liver failure [alanine aminotransferase (ALT) 1821 U/L, aspartate transferase (AST) 2260.7 U/L, glucose (Glu) 1.11 mmol/L], acute renal failure [urea (UREA) 12.18 mmol/L, creatinine (CREA) 163.9 umol/L], and disseminated intravascular coagula-tion (DIC) within 1 day. Amiodarone was discontinued and a combination of hepatoprotective and hemodialysis treatment was added, and the patient’s liver function, renal function, and coagulation function gradually recovered. Considering acute renal failure and DIC as a result of liver failure, the RUCAM causality assessment scale was used, and the score was 6, indicating that the correlation between acute liver failure and amiodarone was very likely.
出处
《临床医学进展》
2022年第8期7433-7439,共7页
Advances in Clinical Medicine
