ACEI类降压药致自身免疫性溶血性贫血2例并文献复习

Hypertensive drug of angiotensin converse enzyme inhibiter-induced autoimmune hemolytic anemia:2 cases report and literature review

目的:提高对自身免疫性溶血性贫血(AIHA)病因多样化的认识。方法:对2例血管紧张素转化酶抑制剂(ACEI)类降压药致AIHA患者的临床资料进行分析,并复习相关文献。结果:2例患者均为急性起病,皮肤巩膜黄染明显,直接和间接抗人球蛋白抗体试验阳性,激素联合静脉丙种球蛋白治疗效果好。结论:ACEI类降压药致AIHA的病例其临床表现、实验室检查和治疗效果与其他原因所致AIHA相比,存在一定的差异。医务工作者在使用ACEI类降压药的过程中应注意AIHA发生的可能。

Objective：To enhance the recognition of the disease diversification of autoimmune hemolytic anemia （AIHA）. Method：Two AIHA patient＇s clinical materials were investigated which was caused by angiotensin converse enzyme inhibiter （ACEI）, and the related literatures were reviewed. Result： Two patients were had abrupt skin and iatrie sclera rapidly, the direct and indirect anti-human-globulin test were positive, and had good effect on hormone, combined vienglobulin. Conclusion：The AIHA caused by angiotensin converse enzyme inhibiter （ACEI） is still rarely reported at present, and there are some differences in the clinical manifestation, laboratory examination and therapeutic efficacy. We should pay attention to this phenomenon.