药物相互作用致三酰甘油升高1例

Case analysis of drug interactions-induced abnormal elevation of triglycerides in a patient

目的报道并分析西罗莫司致高三酰甘油血症1例,提高临床重视西罗莫司对血脂代谢的影响。方法 1例肝移植病人使用西罗莫司后引起高三酰甘油血症的关联性评价及查阅文献印证。结果住院第7日查血生化示:总胆固醇2.80mmol/L,三酰甘油7.74 mmol/L;西罗莫司血药浓度为20 ng/mL;立即停用西罗莫司。住院第14日西罗莫司血药浓度为7 ng/mL,住院第21日复查血生化示:总胆固醇2.75 mmol/L,三酰甘油4.77 mmol/L。结论该肝移植术后病人并发高三酰甘油血症很可能是西罗莫司引起。在应用西罗莫司时,应严密监测病人血脂情况,一旦出现三酰甘油值增加,应及时调整西罗莫司给药方案以期维持其血药浓度在基线范围内,从而降低其对血脂代谢的影响。

Objective To report a case of hypertriglyceridemia caused by sirolimus and to remind physician to pay attention to the the effect of sirolimus on blood lipid metabolism.Methods Evaluate the association between sirolimus regimen therapy and hyperglycemia in 1 patient with liver transplantation.Results Blood biochemical examination on the 7 th day of hospitalization showed total cholesterol of 2.80 mmol/L and triglyceride of 7.74 mmol/L.The blood concentration of sirolimus was 20 ng/mL.Stop sirolimus regimin immediately.On the 14 th day of hospitalization,the blood concentration of siroximus was 7 ng/mL,and the blood biochemical examination on the 21 st day of hospitalization showed total cholesterol of 2.75 mmol/L and triglyceride of 4.77 mmol/L.Conclusion The development of hyperglycemia in this patient after liver transplantation was most likely caused by sirolimus.We should pay more attention to the patient’s blood lipid metabolism during sirolimus regimen therapy.Once the triacylglycerol value increases,the sirolimus regimen therapy should be adjusted in time to maintain the sirolimus concentrations within the baseline range and reduce the effect of sirolimus on blood lipid metabolism.