注射用两性霉素B脂质体致严重贫血、血小板减少、低钾血症1例

Liposomal amphotericin B for injection causing severe anemia,thrombocytopenia and hypokalemia in one case

目的加强两性霉素B脂质体的用药监护,促进临床合理用药。方法对1例应用两性霉素B脂质体导致严重贫血、血小板减少及低钾血症的病例进行关联性评价及文献查阅印证。结果患者应用两性霉素B脂质体累积剂量1000 mg,出现血红蛋白、血小板及血钾降低,最低值分别为30 g/L、37×10^(9)/L、2.77 mmol/L,停药对症处理后,血红蛋白升至72 g/L,血小板升至42×10^(9)/L,K~+升至3.62 mmol/L,症状缓解出院。结论两性霉素B脂质体很可能导致严重贫血、血小板减少、低钾血症。临床在使用过程中应加强监护、密切监测、尽早预防与处理,可降低不良反应程度及发生率,发挥药物最大治疗效果。

Objective To strengthen the medication monitoring of iposomal amphotericin B and promote the rational clinical application.Methods A case of severe anemia,thrombocytopenia and hypokalemia caused by iposomal amphotericin B was evaluated and confirmed by literature review.Results After the cumulative dose of 1000 mg of iposomal amphotericin B,the patients showed decreased hemoglobin,platelet and potassium,with the lowest values being 30 g/L,37×10^(9)/L and 2.77 mmol/L,respectively.After drug withdrawal and the symptomatic treatment,the hemoglobin increased to 72 g/L,the platelet increased to 42×10^(9)/L,and the K~+increased to 3.62 mmol/L,and the patients were discharged with symptom relief.Conclusion Iposomal amphotericin B is likely to cause severe anemia,thrombocytopenia and hypokalemia.In the clinical use,we should strengthen the monitoring and perform close monitoring,early prevention and treatment,which can reduce the degree and incidence of adverse reactions,giving play to the maximum therapeutic effect of drugs.