胺碘酮致心动过缓、低血压及严重肝损害

Bradycardia,hypotension,and severe liver damage due to amiodarone

1例69岁女性患者,因心律失常、阵发性室上性心动过速,HR166次/min,给予胺碘酮150mg静脉推注。30min后,患者出现窦性心动过缓,低血压。HR35次/min,BP81/50mmHg。立即安装临时起搏器,静脉补液,静脉注射多巴胺,1h后缓解。后因心动过速间断发作,再次给予胺碘酮注射液300mg加入5%葡萄糖注射液50ml,以0.6mg/min泵入。次日实验室检查:ALT1770U/L,AST1360U/L,TBil130.20μmol/L,DBil98.40μmol/L;PT17.3s,INR1.45。停用胺碘酮,给予对症、支持治疗。1周后症状好转。

A 69-year-old women received an IV push of amiodarone 150 mg for arrhythmia,paroxysmal supraventricular tachycardia,and a heart rate of 166 beats/min. Thirty minutes later,the patient developed sinus bradycardia and hypotension. Her heart rate was 35 beats/min and blood pressure was 81/50 mm Hg. She was undergone temporary pacemaker. Meanwhile fluid supplementation and an IV dopamine were given. One hour later,her symptoms relieved. She was treated with an IV infusion of amiodarone 300 mg diluted in 5% glucose 50 ml via pump at a rate of 0.6 mg/min for intermittent episodes of tachycardia. The next day,her laboratory tests revealed the following values：ALT 1 770 U/L,AST 1 360 U/L,TBil 130.20 μmol/L,DBil 98.40 μmol/L; PT 17.3 s,INR 1.45. Amiodarone was stopped and she received symptomatic and supportive treatment. One week later,her symptoms improved.