论文部分内容阅读
最近,我们在吡喹酮的临床研究中,发现2例患者分别于服药后60及71小时出现心房颤动(以下简称房颤),特报告于下:例1,褚××,男,25岁,1980年10月17日因粪便孵化血吸虫毛蚴阳性入院。患者平时健壮,无反复感冒、咽痛史,无胸闷、心悸史,无游走性关节肿痛史。体检:发育营养佳,体重58公斤,血压110/78毫米汞柱。心界正常,心率68次/分,律齐,无杂音,两肺呼吸音清晰,肝脾肋下未扪及,血象、尿检正常,血沉4毫米/小时,抗链球菌溶血素“O”正常。胸透:心肺正常。心电图:窦性心律,正常心电图。诊断:慢性血吸虫病、早期。于入院第二天起服用呲喹酮(南京制药厂,批号800702),总剂量为每公斤体重60毫克,分2天4次服完。服药期间无不适,末次服药后1小时复查心电图,同前(图1)。于停药后第三天清晨,即末次服药后60小时,患者感心悸、胸闷,听诊发现心音强弱不等,心律快慢不一,复查心电图,呈典型之房颤,心室率平均96次/分(图2)。在密切观察下,未予药物处理。至中午12时左右,心悸、胸闷消失,听诊心律已转齐,复查心电图,已恢复窦性心律,为正常心电图。停药后5天再复查心电图,正常。
Recently, in a clinical study of praziquantel, we found that two patients developed atrial fibrillation (hereinafter referred to as atrial fibrillation) at 60 and 71 hours after taking the drug, respectively, and were reported as follows: Example 1 Chu × ×, male, 25 years old October 17, 1980 because of stool hatching schistosome cercariae positive admission. Patients usually healthy, no recurrent influenza, sore throat history, no chest tightness, heart palpitations history, no migratory joint swelling and pain history. Physical examination: good nutrition and development, weighing 58 kg, blood pressure 110/78 mm Hg. Heart normal, heart rate 68 beats / min, law Qi, no noise, clear breath sounds of both lungs, liver and spleen ribs palpable, blood, urine test normal, ESR 4 mm / h, anti-streptolysin “O” normal . Chest throat: normal heart and lungs. ECG: sinus rhythm, normal ECG. Diagnosis: Chronic schistosomiasis, early. Taking diethylstilbestrol (Nanjing Pharmaceutical Factory, lot number 800702) on the second day after admission, the total dose was 60 mg / kg body weight and finished taking 4 times in 2 days. During the medication without any discomfort, 1 hour after the last medication ECG review, with the former (Figure 1). In the early morning of the third day after stopping, that is, 60 hours after the last dose, the patient felt palpitation, chest tightness, auscultation found heart sounds vary, heart rate varies, review of ECG, typical of atrial fibrillation, ventricular rate average 96 times / Points (Figure 2). Under close observation, no drug treatment. Around 12 noon, palpitations, chest tightness disappeared, auscultation of cardiac rhythm has been transferred to the review ECG, sinus rhythm has been restored for the normal ECG. Five days after stopping the re-examination of ECG, normal.