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患者男,63岁。复杂部分性发作史10年。用苯妥英钠(PHT)400mg/天控制发作。两次测定其血清稳态浓度为72.9μmol/L和78.4μmol/L。因严重的心绞痛分别于1993年、1994年做经皮穿刺冠状动脉扩张术(PTA),术后PHT浓度无变化。1995年4月又一次PTA并置入血管支架(Stent)后增加噻氯匹啶25mg,每日两次,防止冠脉闭塞。此后3周内出现眩晕、共济失调、倦睡,血清PHT浓度138.6μmol/L。3天后达162.4μmol/L。
Male patient, 63 years old. Complex partial seizures for 10 years. With phenytoin sodium (PHT) 400mg / day control seizures. Serum steady-state concentrations of 72.9 μmol / L and 78.4 μmol / L were determined twice. Percutaneous coronary angioplasty (PTA) was performed in 1993 and 1994, respectively, due to severe angina pectoris. There was no change in postoperative PHT concentration. In April 1995, once again, PTA was placed in the stents and added ticlopidine 25mg twice daily to prevent coronary occlusion. After 3 weeks, dizziness, ataxia, drowsiness, serum PHT concentration 138.6μmol / L. After 3 days 162.4μmol / L.