氨氯地平过量致多器官功能不全及胸腹腔积液

Amlodipine overdose-induced multiple organ dysfunction syndrome(MODS) as well as pleural and abdominal effusions

1例27岁女性患者自行服用氨氯地平(5 mg/片)42片3,0 min后出现头晕、反复呕吐,BP为73/41 mm Hg。给予补液和多巴胺静脉泵入提升血压。入院第2天患者15 h尿量仅200 mL,其BUN和SCr分别为12.4 mmol/L和158μmol/L,并出现胸闷、气短,SpO2 92%,颜面水肿。超声检查示胸腹部大量积水,遂行胸腔引流术放出胸腔积液以减轻心、肺压迫症状。入院第3天其ALT和AST分别为117 U/L和89 U/L。第5天开始患者出现多尿,达平均4000 mL/d,血钾由3.4 mmol/L降到2.5 mmol/L,给予补钾。第7天患者尿量恢复正常,血钾升至3.45 mmol/L。患者住院11 d,痊愈出院。

A 27-year-old woman self-medic ated with 42 tablets of amlodipine 5 mg and,30 minutes later,developed repeated vomiting accompanied by a BP of 73/41 mm Hg.She was given IV fluid supplement and dopamine via IV pump for maintaining blood pressure.On day 2 of admission,her urine volume decreased to 200 mL within 15 hours,her BUN and SCr were 12.4 m mol/L and 158 μmol/L,respectively.The patient gradually developed chest tight ness,short of breath,SpO2 of 92% and facial edema.Ultrasound examination showed massive pleural and abdominal effusions,and she underwent pleural drainage for aspirating effusions and relieving oppressive symptoms in the heart and lungs.On hospital day 3,her ALT and AST levels were 117 U/L and 89 U/L,respectively.On day 5,the patient developed polyuria with a urine volume up to,on aver age,4 000 mL a day,and her serum potassium levels decreased from 3.4 mmol/L to 2.5 mmol/L.She was treated with a potassium supplement.On day 7,her urine volume was normal and her serum potassium level increased to 3.45 mmol/L.Eleven days after hospitalisation,the patient recovered and was discharged.