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1例71岁女性患者因甲状腺功能亢进性心脏病,给予环磷腺苷40 mg加入0.9%氯化钠注射液250 ml静脉滴注。用药5 min后,患者出现剧烈腰痛、心悸,30 min后出现双侧眼睑水肿、胸闷、呕吐。血压180～190/100～105 mm Hg(1 mm Hg=0.133 kPa),两下肺闻及湿啰音。肾功能检查:潜血(+++),蛋白质(+++),红细胞1～2个/高倍视野。立即停用环磷腺苷,给予吸氧、地塞米松、呋塞米、奥美拉唑和硝苯地平治疗。约2 h后,患者排出尿量>1000 ml,血压159/65 mm Hg,心率85次/min,血氧饱和度0.97,双肺湿啰音明显减少。3 d后患者基本恢复正常。
A 71-year-old female patient was given an IV infusion of 40 mg of cyclic adenosine monophosphate and 250 mL of 0.9% sodium chloride injection for hyperthyroid heart disease. 5 min after treatment, patients with severe back pain, heart palpitations, bilateral eyelid edema after 30 min, chest tightness, vomiting. Blood pressure 180 ~ 190/100 ~ 105 mm Hg (1 mm Hg = 0.133 kPa), two lung smear and wet rales. Renal function tests: occult blood (+++), protein (+++), red blood cells 1 to 2 / high power field. Immediate withdrawal of cyclic adenosine monophosphate, given oxygen, dexamethasone, furosemide, omeprazole and nifedipine treatment. After about 2 hours, the patient discharged urine volume> 1000 ml, blood pressure 159/65 mm Hg, heart rate 85 beats / min, oxygen saturation 0.97, lung wet rales significantly reduced. After 3 days, the patient returned to normal.