长期使用以脂肪乳为基质的药物致Ⅲ/Ⅳ度血小板下降三例

Grade Ⅲ/Ⅳ thrombocytopenia induced by drug with fat emulsion as stroma: 3 case reports

1例长期使用中长链脂肪乳、氟比洛芬酯的鼻咽癌患者,在未做放化疗期间发生Ⅳ度血小板减少,未停药情况下输注血小板、升血小板药物无效;1例长期使用榄香烯脂肪乳的肺癌患者Ⅲ度血小板减少,输血小板后恢复,再次使用氟比洛芬酯、中长链脂肪乳后血小板Ⅱ度减少;1例食管癌患者使用榄香烯后血小板逐日下降至Ⅲ度,停药后渐升,再次使用又下降。这4种药物皆含有脂肪乳,提醒医生关注长期使用脂肪乳引起血小板下降的现象。

The grade Ⅳ thrombocytopenia appeared on a nasopharyngeal carcinoma patient with long-term use of medium and long chain fat emulsion and flurbiprofen without radiotherapy and chemotherapy. Platelet transfusions,elevating platelet drugs were invalid without stopping the drugs,the patient’s granulocyte,monocyte was normal. The grade Ⅲ thrombocytopenia occurred on a lung cancer patient with long term use of elemene. It recovered by platelet transfusion whereas grade Ⅱ thrombocytopenia after flurbiprofen and long chain fat emulsion used again. The platelet of esophageal cancer patient decreased day by day to Ⅲ degree using elemene,increased withdrawal the drug and declined when using again. Fat was contained in the 4 kinds of drugs. Clinical pharmacist reminded doctors about fat overload syndrome caused by long term use of fat emulsion.