注射用阿奇霉素致过敏性休克伴一过性听力下降1例

One case report of allergic shock with temporary hearing loss induced by azithromycin for injection

1例59a女性急性支气管炎患者,给予5%葡萄糖注射液250mL加注射用阿奇霉素0.5g静脉滴注,滴注35min后,患者出现冷汗、头晕、黑朦、听力下降(听声音微弱、遥远)、胸闷、心悸、手麻,即停止输液。查体:神志恍惚,面色苍白,四肢末端湿冷,R28次·min-1,脉搏细速,HR128次·min-1,律齐,心音减弱,BP50/40mmHg。考虑过敏性休克,给予吸氧,改换5%葡萄糖注射液及0.9%氯化钠注射液静脉滴注;给予肾上腺素、地塞米松治疗,30min后血压、听力等恢复正常。除输液扩容外,抗感染治疗改用0.9%氯化钠注射液250mL加痰热清注射液20mL静脉滴注。治疗结束后观察6h患者无异常表现。

A 59-year-old woman with acute bronchitis was given 250 mL of 5% glucose solution with 0.5 g of azithromycin for injection.After 35 minutes of the infusion,the patient showed cold sweat,dizziness,amaurosis,hearing loss（hearing the voice faint and distant）,chest tightness,palpitation,numbness of hand,then the infusion was stopped immediately.Physical examination showed wandering,pallor,cold clammy limbs,a respiratory rate of 28 breaths per minute,heart rate of 128 beats per minute,diminished heart sounds,and blood pressure was 50/40 mmHg,which accorded with the symptoms of anaphylactic shock.Then the patient was given such treatments as oxygen uptake,5% glucose solution and 0.9% sodium chloride solution by intravenous infusion,epinephrine and dexamethasone.After 30 minutes,blood pressure and hearing of the patient returned to normal.In addition to fluid expansion,the anti-infection treatment was changed to 250 mL of 0.9% sodium chloride solution and 20 mL of Tanreqing injection.No abnormal appearance was observed for 6 hours after the end of treatments.