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1例71岁男性患者因肺烟曲霉菌病,用伏立康唑治疗,第1天静脉滴注伏立康唑300mg,2次/d;第2天200mg,2次/d。用药2d后患者出现呼吸急促,心率加快,不能平卧。血气分析示pH值7.32,PO27.02kPa,PCO28.59kPa,BE-6.25;第4天患者24h尿量减少为300mL/24h,BUN28.32mmol/L,SCr318μmol/L,考虑为伏立康唑引起的Ⅱ型呼吸衰竭和急性肾衰竭。遂停用伏立康唑,改为米卡芬净100mg/d静脉滴注,同时对症处理和血液透析。3d后患者逐渐恢复正常。
One 71-year-old male patient was treated with voriconazole due to Aspergillus fumigatus. Voriconazole 300 mg was given intravenously on day 1 twice a day for 200 mg twice a day for 2 days. Patients 2d after treatment appears shortness of breath, heart rate, can not supine. Blood gas analysis showed pH value of 7.32, PO27.02kPa, PCO28.59kPa, BE-6.25; the first four days of patients 24h urine output was reduced to 300mL / 24h, BUN28.32mmol / L, SCr318μmol / L, consider Voriconazole induced type II respiration Failure and acute renal failure. Then voriconazole was discontinued, replaced with micafungin net 100mg / d intravenous infusion, while symptomatic treatment and hemodialysis. After 3d patients gradually returned to normal.