呋喃唑酮致急性肺损伤

Acute lung injury due to furazolidone

1例47岁女性幽门螺杆菌(HP)感染患者接受HP根治方案(泮托拉唑肠溶片40 mg口服、2次/d,阿莫西林胶囊1 g口服、2次/d,呋喃唑酮片0.1 g口服、3次/d)治疗。患者曾多次服用阿莫西林胶囊和泮托拉唑肠溶片,未出现不良反应。接受HP根治方案第12天,患者出现发热、气促,体温38.3℃,同时出现右眼球结膜出血。实验室检查示嗜酸粒细胞0.08,胸部CT示两肺间质性水肿、右侧胸腔少量积液。考虑为急性肺损伤,可能与呋喃唑酮有关。停用该药,给予糖皮质激素和对症治疗。6 d后,患者发热、气促等症状缓解,右眼结膜出血吸收,实验室检查示嗜酸粒细胞0.008,胸部CT示两肺间质性水肿较前吸收,右侧胸腔积液基本吸收。

A 47-year-old female patient with Helicobacter pylori(HP)infection received anti-HP regimen,including pantoprazole enteric coated tablets 40 mg orally twice daily,amoxicillin capsules 1 g orally twice daily,and furazolidone tablets 0.1 g orally thrice daily.The patient had previously taken amoxicillin capsules and pantoprazole enteric coated tablets several times without adverse reactions.On the 12th day after receiving anti-HP treatment,the patient developed fever,shortness of breath,body temperature of 38.3℃,and conjunctival hemorrhage of the right eyeball.Laboratory tests showed that percentage of eosinophils was 0.08.Chest CT showed interstitial pulmonary edema in bilateral lungs and a small amount of effusion in the right pleural cavity.Acute lung injury associated with furazolidone was considered.Furazolidone was stopped.The patient received glucocorticoid and symptomatic treatments.Six days later,the patient's symptoms such as fever and shortness of breath were relieved and the conjunctival hemorrhage in the right eye was absorbed;laboratory test showed that percentage of eosinophils was 0.008;the chest CT showed that the interstitial pulmonary edema in bilateral lungs was more absorbed than before and the pleural effusion on the right side was basically absorbed.