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作者报告1例17岁男病人,体重55kg,因严重的喘鸣和呼吸窘迫而入院。在过去三年曾多次发作过。病人住入 ICU 后的2周内应用了氨茶碱7.2g 和氢化考的松17g。为了便于进行通气和降低通气道阻力而注射潘侃朗宁,单次注射2mg 常不能停止其费力的自主呼吸和不安,不得不行持续点滴,当剂量达5mg/小时方能收效。在2周内共应用潘侃朗宁800mg。在病情好转,停药后1小时即能睁眼和启动口唇,但无自主呼吸。周围神经电刺激显示部分非去极化阻滞。静注腾喜龙10mg 之后肌张力迅速改善。作者考虑,病人之所以需如此大剂量的潘侃朗宁,与应用大量的氨茶碱类固醇密切相关。因氨茶碱可抑制磷酸二酯酶,使体内 cAMP 水平增高,促使神经肌肉接点的乙酰胆碱水平增加,从而拮抗潘侃朗宁的作用。同样的,大剂量氢化考的松也有利
The authors report a 17-year-old male patient, weighing 55 kg, who was hospitalized for severe wheezing and respiratory distress. In the past three years had multiple attacks. Aminophylline 7.2g and hydrocortisone 17g were applied within 2 weeks of the patient’s admission to the ICU. In order to facilitate ventilation and reduce airway resistance and injection Pan Kan Lang Ning, a single injection of 2mg often can not stop their laborious spontaneous breathing and restlessness, had to continue to drip, when the dose of 5mg / hour before being effective. Pan Kan Langning 800mg in 2 weeks. In the condition improved, 1 hour after stopping can open his eyes and lips, but no spontaneous breathing. Peripheral electrical stimulation showed partial non-depolarization block. After intravenous injection of Tengxilong 10mg muscle tension improved rapidly. The authors consider that the reason why patients need such a large dose of Pan Kan Lang Ning, and the use of large amounts of aminophylline steroids are closely related. Because aminophylline can inhibit phosphodiesterase, so that increased levels of cAMP in vivo, to promote neuromuscular junction acetylcholine levels, thereby antagonizing the role of Pan Kan Langning. Similarly, high-dose hydrocortisone is also beneficial