乳酸左氧氟沙星氯化钠注射液致严重低血糖

Severe hypoglycemia due to levofloxacin lactate and sodium chloride infusion

1例78岁女性2型糖尿病患者因恶心、呕吐、反酸、腹泻3d,先后静脉滴注注射用奥美拉唑钠20 mg和乳酸左氧氟沙星氯化钠注射液0.3 g。静脉滴注乳酸左氧氟沙星氯化钠注射液约10 min后患者出现大汗、心慌、面色苍白、意识淡漠,即测血糖3.0 mmol/L。暂停静脉滴注乳酸左氧氟沙星氯化钠注射液,给予葡萄糖氯化钠注射液500 ml静脉滴注,并进食糖块、面包,约5 min后症状缓解。恢复静脉滴注乳酸左氧氟沙星氯化钠注射液,约5 min后前述症状复现,即刻血糖为1.9 mmol/L。立即停用乳酸左氧氟沙星氯化钠注射液,静脉推注50%葡萄糖注射液20 ml后继续静脉滴注5%葡萄糖注射液500 ml,约10 min后患者低血糖症状消失,输液结束后血糖升至9.6 mmol/L。

A 78-year-old woman with type 2 diabetes received an IV infusion of omeprazole sodium injection 20 mg and levofloxacin lactate and sodium chloride injection 0. 3 g successively for nausea, vomiting, acidic regurgitation, and diarrhea for 3 days. The patient developed hyperhidrosis, palpitation, pale, and unconsciousness 10 minutes after IV infusion of levofloxacin lactate and sodium chloride infusion. Laboratory examination showed blood glucose was 3.0 mmol/L. Levofloxacin lactate and sodium chloride infusion was discontinued temporarily. She was given an IV infusion of glucose saline 500 ml, candy and bread. Five minutes later, her symptoms were mitigated. An IV infusion of levofloxacin lactate and sodium chloride infusion was given again. The symptoms mentioned above recurred 5 minutes later. Laboratory examination showed blood glucose was 1.9 mmol/L. Levofloxacin lactate and sodium chloride infusion was withdrawn immediately, and an IV bolus of 50% glucose 20 ml and IV infusion of 5% glucose 500 ml were given successively. Ten minutes later, her hypoglycemia symptoms disappeared, and the blood glucose increased to 9.6 mmol/L.