那如三味丸致严重心律失常及休克

Severe arrhythmia and shock attributed to Narusanwei pills

1例22岁女性患者因牙龈肿痛自行服用那如三味丸5粒。30min后出现胸痛、头晕、恶心。6h后症状加重伴呕吐、面色苍白、四肢末梢紫绀入院。立即给予吸氧及心电监护。查体:BP80/50mmHg,神志淡漠、意识模糊。心电图:频发室性早搏二联律,室性颤动。急查心肌酶谱:AST151.1U/L,LDH532U/L,CK1113U/L,CK-MB135.5U/L,α-HBDH427U/L,肌钙蛋白T1.60μg/L。诊断为频发室性早搏,室性颤动,药物性心肌损害,心源性休克。给予补钾、静脉滴注多巴胺及对症治疗,病情改善。继续治疗15d痊愈出院。随访2个月无复发。

A 22-year-old woman received 5 Narusanwei pills for gingival swelling and pain. Thrity minutes later, the patient developed chest pain, dizziness, and nausea. He was hospitalied with aggravated symptoms accompanied by vomiting, pale, and peripheral cyanosis of limbs after 6 hours. He was treated with oxygen inhalation and underwent ECG monitoring immediately. An examination revealed a BP of 80/50 mm Hg, apathy, and confusion. ECG showed frequent ventricular extrasystole with bigeminy and ventricular fibrillation. The myocardial enzyme tests revealed the following levels： AST 151.1 U/L, LDH 532U/L, CK 1113U/L, CK- MB 135. 5U/L, α-HBDH 427U/L, and troponin T 1. 60 μg/L. He was diagnosed with frequent ventricular premature beats, ventricular fibrillation, drug-induced cardiac damage, and cardiac shock. A potassium supplement, an IV infusion of dopamine, and symptomatic therapy were given. Her condition improved. And he recovered after 15days of further treatment. The patient had no recurreace of any symptoms at 2-month follow-up .