左氧氟沙星注射液致过敏性休克及肝功能损伤

Anaphylactic shock with liver damage caused by levofloxacin injection

1例61a女性患者,因泌尿系感染予以甲磺酸左氧氟沙星注射液0.2g,bid治疗。用药10min后出现寒战、头晕、视力模糊、四肢冰冷、BP80/60mmHg。血生化示:Cr158μmol·L-1,BUN3.33mmol·L-1,Glu9.64mmol·L-1,ALT195IU·L-1,AST141IU·L-1,予以扩容后生命体征恢复平稳。入院完善检查后,排除酒精性肝病,病毒性肝炎以及自身免疫性肝病。予以还原型谷胱甘肽、多烯磷脂酰胆碱护肝治疗12d,病情好转后出院。出院时,肾功能已经恢复;口服护肝药治疗1个月后肝功能恢复。

A 61-year-old female patient received intravenous infusion of levofloxacin mesylate 0.2 g twice daily for urinary tract infection.About 10 minutes after infusion start,the patient presented chilliness,dizziness,blurred vision,cold limbs,with blood pressure of 80/60 mmHg.Laboratory test revealed the followings：Cr 158 μmol·L-1,BUN 3.33 mmol·L-1,Glu 9.64 mmol·L-1,ALT 195 IU·L-1 and AST 141 IU·L-1.The vital signs of patient stabilized after expansion treatment.Then the patient was hospitalized and the laboratory test results eliminated alcoholic liver disease,viral hepatitis and autoimmune liver disease.After 12-day treatment with reduced glutathione and polyene phosphatidylcholine for liver damage,patient＇s conditions improved and renal function turned to normal,and then she discharged from hospital.After a month of oral medications treatment,her hepatic function normalized.