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甲氰咪呱临床已广泛应用,但诱发支气管哮喘急性发作,临床少有报告,现将本人所遇两例报告如下: 例1 男患、63岁,反复咳喘史20余年,逐年加重。近3年发作频繁。咳喘伴发热、黄痰5天入院。入院后并发右侧气胸,经抗感染、解痉止喘、吸氧及胸腔闭式引流等综合治疗3天,气胸完全吸收,肺部哮鸣者减少,病情好转,入院第6天频繁呕吐咖啡色液体伴柏油便。给予甲氰咪呱400mg每日二次静滴共3天,呕吐止,黑便消失,但哮喘加重,肺部满布哮鸣音,重新使用平喘药物效果不佳。因消化道出血停止而停用甲氰咪呱:1天后哮喘缓解。后经消化道钡透提示胃小弯溃疡,重新口服甲氰咪呱,2天后哮喘复发,遂考虑甲氰咪呱所诱发。停用该药,一般平喘治疗好转,哮鸣音消失。住院50天,好转出院。例2 男患,农民,34岁,支气管哮喘史10余年,每年冬季发作频繁,经一般平喘药物治疗可缓解。近3月来上腹痛,伴嗳气返酸,经上消化道钡透检查,诊断十二指肠球部溃疡,即给甲氰咪呱口
Cimetidine clinical has been widely used, but the acute bronchial asthma attack induced, few clinical reports, I now encounter two cases reported as follows: Example 1 Male patients, 63 years of history, repeated cough and asthma over 20 years, increasing year by year. The past three years episodes frequently. Cough with fever, yellow sputum admitted to hospital for 5 days. Admitted to the right pneumothorax after admission, anti-infective, antispasmodic and anti-asthma, oxygen and thoracic closure of the drainage and other comprehensive treatment for 3 days, the pneumothorax was completely absorbed, reduced lung wheeze, condition improved, 6 days of admission frequent vomiting brown Liquid with asphalt. Given cimetidine 400mg twice daily intravenous infusion of a total of three days, vomiting only, black will disappear, but asthma exacerbated lung full of wheezing, re-use of antiasthmatic drugs ineffective. Cimetidine stopped due to cessation of gastrointestinal bleeding: Asthma relief after 1 day. After the barium through the digestive tract prompted gastric ulcer, re-oral cimetidine, 2 days after the recurrence of asthma, then consider cidacimidine induced. Disable the drug, general asthma treatment improved wheeze disappeared. Hospitalized for 50 days, improved discharged. Example 2 male suffering, farmer, 34 years old, history of bronchial asthma more than 10 years, frequent seizures every winter, the general antiasthmatic drugs can be alleviated. Nearly three months to the upper abdominal pain, with carbuncle back to acid, barium through the upper gastrointestinal tract examination, diagnosis of duodenal ulcer,