服用安乃近片致过敏性休克死亡

Death from anaphylactic shock following taking metamizole sodium tablets

1例38岁男性患者因感冒自服安乃近3片(0.5 g/片)。约30 min后,患者出现头晕、胸闷、乏力,面部、颈部、躯干及四肢出现红色瘀点和瘀斑。3 h后因病情加重入院。查体:T37.2℃,HR 118次/min,R 32次/min,BP 30/0 mm Hg,烦躁不安,意识障碍,全身湿冷,尿失禁,双侧瞳孔散大。血常规:WBC 12.6×109/L,N0.80,PLT136×109/L。心电图示心动过速,窦性心律不齐。给予肾上腺素、地塞米松、异丙嗪、碳酸氢钠治疗,但抢救无效,患者死亡。

A 38-year-old man took 3 metamizole sodium 0.5 g tablets himself for a cold. About 30 minutes later, the patient developed dizziness, chest distress, asthenia, and red petechiae and ecchymoses on his face, neck, trunk, and extremities. Three hours later, the patient was hospitalized with aggravated symptoms. An examination revealed a temperature of 37.2℃, a heart rate of 118 beats/min, a respiratory rate of 32 breaths/min, and a BP of 30/0 mm Hg. She experienced agitation, uneonsciousness, general clamminess, incontinence of urine, and bilateral mydriasis. Routine blood tests revealed the following： WBC count 12.6 × 10^9/L with 80% neutrophils, platelet count 136 × 10^9/L. An EGG showed tachycardia and sinus arrhythmia. Despite treatment with adrenaline, dexamethasone, promethazine, and sodium bicarbonate, the resuscitation was unsuccessful and he died.