警惕泼尼松引起的心功能不全

Cardiac Dysfunction Caused by Prednisone

目的探讨泼尼松致心功能不全的临床特点及发生原因。方法对应用泼尼松治疗脑卒中后肩手综合征致心功能不全1例的临床资料进行回顾性分析。结果本例为73岁男性,因脑卒中后出现肩手综合征入院治疗,予泼尼松治疗10 d后逐渐出现烦躁、气急、端坐呼吸伴双下肢水肿,行心脏彩色多普勒超声检查示左室射血分数45%;查脑利钠肽2319 ng/L,考虑为泼尼松引起的心功能不全,予利尿等对症治疗后烦躁、气喘及双下肢水肿好转,病情好转出院。结论对于有基础性心脏病的老年人,使用糖皮质激素时应警惕心功能不全或致其病情加重。

Objective To study the typical clinical features of cardiac dysfunction caused by Prednisone in order to reduce misdiagnosis and mistreatment. Methods We retrospectively analyzed the clinical data of a case of Prednisone-related cardiac dysfunction. Results We used Prednisone to treat the shoulder-hand syndrome or type 1 complex regional pain syndrome for a 73 year-old male stroke survivor. About 10 days after using Prednisone,the patient presented progressive dysphoria,dyspnea,and orthopnea in sleep. The patient had a sign of swelling in both the lower extremities. Cardiac ultrasound showed that left ventricle ejection fraction（ LVEF） was 45%,and the blood Pro-BNP was 2319 ng / L. It was suspected as cardiac dysfunction. After treatment of furosemide,aldactone and limiting the patient＇s activity,the patient＇s cardiac symptom was alleviated quickly. Conclusion This case illustrates the importance of preventing the elderly patients with cardiac conditions from developing serious cardiac dysfunction in administering Prednisone or other types of corticosteroid.