甲磺酸左氧氟沙星氯化钠注射液致窦性心动过缓

Sinus bradycardia caused by levofloxacin mesylate and sodium chloride injection

1例51岁女性患者因急性胃肠炎、肺炎静脉滴注甲磺酸左氧氟沙星氯化钠注射液（左氧氟沙星）0.4 g,1次/d.用药第10天,患者出现头晕、胸闷、心悸,脉搏45次/min,心率47次/min,血压105/56 mmHg（1 mmHg=0.133 kPa）,心电图示窦性心动过缓、窦性心律不齐.考虑与左氧氟沙星有关.给予低流量吸氧,并予异丙肾上腺素1 mg静脉滴注.1 h后,患者脉搏65次/min,心率67次/min,血压120/76 mmHg,头晕缓解,复查心电图示窦性心律.医生口述停用左氧氟沙星,但未纪录在病历中.次日,再次给患者静脉滴注左氧氟沙星0.4g,5h后上述症状再次出现,心电图示窦性心动过缓,心率53次/min.经采用与前一日相同治疗措施后,患者恢复.

A 51-years-old female patient with acute gastroenteritis and pneumonia received an IV infusion of levofloxacin mesylate and sodium chloride injection 0.4 g once daily. On day 10,the patient developed dizziness,chest tightness,and palpitations. Her pulse rate was 45 beats/min,heart rate was 47 beats/min,and blood pressure was 105/56 mmHg（1 mmHg =0.133 kPa）. Electrocardiogram revealed sinus bradycardia and sinus arrhythmia. The electrocardiographic change was considered to be related to levofloxacin mesylate and sodium chloride injection treatment. Low flow oxygen and an IV infusion of isoproterenol 1 mg were given. After 1 hour,the patient pulse rate was 65 beats/min,heart rate was 67 beats/min,blood pressure was 120/76 mmHg,dizziness relieved. The electrocardiogram showed sinus rhythm. The levofloxacin mesylate and sodium chloride injection was stopped by the doctor orally,however, the treatment was not recorded in the medical record. The next day,levofloxacin mesylate and sodium chloride injection 0.4 g was given again. The above symptoms recurred after 5 hours. The electrocardiogram showed sinus bradycardia,the heart rate was 53 beats/min. After the same treatment as that used the previous day,the patient recovered.