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本文报道1例用利福平治疗后引起的急性阿狄森氏危象。患者,男59岁,因患第9,10胸椎结核,每日给予利福平600mg、异烟肼400mg 和乙胺丁醇1200mg 化疗,13天后,患者出现呕吐、腹痛、发热、极度虚弱、站立时头昏。查体:中度脱水、T 38.5℃、脉细、脉率120次/min、卧位血压100/60mmHg、坐位70/0mmHg,立位50/0mmHg,神经系统检查无明显异常。血浆生化检查:尿素6.4mMol/L、钠118mMol/L、钾4.8 mMol/L、糖6.1mMol/L。根据病情进行简化的 Synacthen 试验,然后停止抗结核药治疗,每6小时给予氢化可的松200mg.根据 Synacthen 试验结果,确诊为急性阿狄森氏危象。检测结果表明,血清和尿的抗利尿激素
This article reports a case of acute Addison’s crisis after treatment with rifampicin. The patient, male, 59 years old, suffered from nosie 9 and 10 thoracic tuberculosis. Rifampicin 600 mg, isoniazid 400 mg and ethambutol 1200 mg were given daily. After 13 days, the patient developed vomiting, abdominal pain, fever, extreme weakness and standing When dizzy. Physical examination: moderate dehydration, T 38.5 ℃, pulse fine, pulse rate 120 beats / min, supine blood pressure 100 / 60mmHg, sitting 70 / 0mmHg, standing 50 / 0mmHg, nervous system examination no obvious abnormality. Plasma biochemical tests: urea 6.4mMol / L, sodium 118mMol / L, potassium 4.8mMol / L, sugar 6.1mMol / L. A simplified Synacthen test was performed based on the condition, and then antituberculotics were stopped and hydrocortisone 200 mg was given every 6 hours. According to the Synacthen test, an acute Addison’s crisis was diagnosed. Test results showed that serum and urine of anti-diuretic hormone