唑来膦酸注射液诱发支气管哮喘

Bronchial asthma due to zoledronic acid injection

1例77岁女性患者因骨质疏松症接受唑来膦酸注射液5 mg静脉滴注。该患者既往有哮喘病史,用药前无哮喘发作。静脉滴注唑来膦酸注射液19 h后,患者出现喘憋、呼吸困难,肺部可闻及哮鸣音,诊断为支气管哮喘发作,考虑为唑来膦酸注射液所诱发。立即给予甲泼尼龙静脉滴注,多索茶碱静脉泵入,沙丁胺醇联合异丙托溴铵及吸入用布地奈德雾化吸入,30 min后喘憋和呼吸困难症状缓解。26 h后支气管哮喘再次发作,再次给予上述治疗后好转。但患者活动耐量下降,予布地奈德福莫特罗粉吸入剂及孟鲁司特钠口服治疗,3个月后活动耐量恢复至静脉滴注唑来膦酸注射液之前。

A 77-year-old female patient received an intravenous infusion of zoledronic acid injection 5 mg for osteoporosis,fhe patient had a history of asthma and no asthma attacks before medication.Nineteen hours after the intravenous infusion of zoledronic acid injection,the patient developed asthma,dyspnea,and wheezing in both lungs.Bronchial asthma attack was diagnosed,which was considered to be induced by zoledronic acid injection.An Ⅳ in fusion of methylprednisolone,venous pumping of doxofylline,and aerosol inhalation of salbutamol,ipratropium bromide,and budesonide for inhalation were given immediately.Thirty minutes later,her symptoms of asthma and dyspnea were relieved.Twenty-six hours later,bronchial asthma recurred and was improved again after the above treatments.However,the patient's exercise tolerance decreased.After 3 months of treatments with inhalation of budesonide and formoterol fumarate powder for inhalation and oral administration of montelukast,her exercise tolerance returned as before zoledronic acid injection.