异烟肼和乙胺丁醇致患者药物热1例的特征分析及其对策

Characteristic Analysis on Patient with Drug Fever Induced by Isoniazid and Ethylenebutanol and Its Countermeasure

目的:分析异烟肼和乙胺丁醇同时致患者药物热的临床特征及其对策,供临床合理用药参考。方法:收治的1例肺结核患者接受异烟肼和乙胺丁醇治疗导致药物热患者,分析其临床资料及治疗对策。结果:1例31岁男性肺结核患者接受HRZE四联抗结核治疗用药4 d后,患者出现发热,体温39.5℃,伴头痛;停用所有药物后体温24 h内恢复正常,再次试用异烟肼当天发热,停药后体温正常;试用乙胺丁醇当天出现发热伴头痛、轻度肝损,停用后体温复常;第2次停药1周后,根据药物热的发生情况,逐个加用阿米卡星、盐酸左氧氟沙星、吡嗪酰胺、利福平治疗,患者体温复常。结论:该患者的药物热可能与异烟肼、乙胺丁醇的使用有关。

Objective： To analyze the characteristics of patient with drug fever induced by isoniazid（H） and ethylenebutanol（E） and its countermeasure, and to provide a reference for rational use of drugs in clinical. Methods： One patient with tuberculosis received the treatment of isoniazid and ethylenebutanol leading to drug fever, and the clinical data and treatment strategies were analyzed. Results： A 31-year-old male patient was given isnoiazid（H）, ethambutol（E）,rifampicin（R）and pyrazinamide（Z）anti-tuberculosis treatment for tuberculosis. After 4 days, the patient had fever with the highest temperature of 39.5 ℃ and a headache; the patient＇s temperature returned to normal within 24 hours after all drugs were discontinued. After another trial of isoniazid, the fever occurred on that day, and the body temperature was normal after drug withdrawal. On the day of the trial of ethylenebutanol, there was fever with headache and mild liver damage, and the body temperature was normal after the suspension. One week after the second withdrawal, amikacin（Amk）, levofloxacin hydrochloride（Lfx）, Z and R were added one by one,the patient had nomoal temperature. Conclusion： The patient＇s drug fever may be related to the use of isoniazid and ethambutol.