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作者报告2例银屑病患者因同时服氨甲喋呤(MTX)和保泰松而发生药物中毒,临床上出现MTX过量的症状,据推测,可能是保泰松把MTX从血浆蛋白结合点取代出来,从而使游离的MTX浓度增加所致。病例1:男,65岁,患银屑病多年,病情严重且常反复。既往口服MTX治疗,平均每周15毫克(24小时内)无严重不良反应。局部外涂倍他米松霜。此次系因皮肤广泛表浅糜烂和体温增高而入院。病史中询得患者在每周一次的MTX(15毫克)治疗之先曾因疼痛性颈骨关节炎服过2天保泰松,100毫克,2次/日。检查:自觉皮肤烧灼感和触痛,口角和下唇溃疡。体温38℃。血红蛋白、白细胞和血小板
The authors report that two patients with psoriasis were poisoned by concurrent methotrexate (MTX) and phenylbutazone and that there was clinical evidence of MTX overdose, presumably due to the possibility of phenylbutazone replacing MTX from the plasma protein binding site, Thus resulting in an increase in free MTX concentration. Case 1: Male, 65 years old, suffering from psoriasis for many years, the condition is serious and often repeated. Previous oral MTX treatment, the average weekly 15 mg (24 hours) no serious adverse reactions. Topical coated with betamethasone cream. The Department of extensive skin due to superficial erosion and increased body temperature and admission. Patient history Patient was challenged with phenylketone for 2 days prior to treatment of painful osteoarthritis with MTX (15 mg) once a week, 100 mg twice daily. Check: Conscious skin burning and tenderness, mouth and lower lip ulcers. Body temperature 38 ℃. Hemoglobin, white blood cells and platelets