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目的 :了解老年慢性阻塞性肺疾病 (慢阻肺 )患者院前氨茶碱中毒的临床特征 ,为临床安全有效地用药提供参考。方法 :对入院前氨茶碱浓度 >2 0ug ml,有毒性反应的老年慢阻肺患者 40例的临床表现、用药情况等进行分析。结果 :即使在日剂量不超过极量的情况下 ,老年慢阻肺患者院前中毒发生率仍较高 ,中毒反应以厌食等消化道症状及心律失常、头晕、头痛多见 ,主要原因为脏器功能不全 ;联合应用抗生素、H2 受体阻滞剂、糖皮质激素会减少氨茶碱的清除率 ,增加血药浓度。结论 :对于使用氨茶碱的老年人 ,应根据脏器功能状况和其他方面的个体差异、联合用药等严格掌握日剂量 ,并根据血药浓度的监测和细致的临床观察 ,及时发现和处理毒性反应。
Objective: To understand the clinical features of pre-hospital aminophylline poisoning in elderly patients with chronic obstructive pulmonary disease (COPD), and to provide a reference for the safe and effective clinical medication. Methods: Pre-admission aminophylline concentration> 200ug ml, toxic reaction in elderly COPD patients 40 cases of clinical manifestations, drug use were analyzed. Results: The incidence of prehospital poisoning was still high in patients with chronic obstructive pulmonary disease (COPD), even in the case of no more than daily doses. The most common cause of gastrointestinal symptoms such as anorexia and arrhythmia, dizziness and headache were mainly due to dirty Incomplete; combined use of antibiotics, H2 receptor blockers, glucocorticoids will reduce the clearance rate of aminophylline, increased plasma concentration. CONCLUSIONS: For the elderly using aminophylline, the daily dose should be strictly controlled according to the functional status of the organ and other individual differences, and the combination therapy. In addition, the monitoring and careful clinical observation of the blood concentration should timely detect and handle the toxicity reaction.