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本文首次详细记录了1例异烟肼引起急性胰腺炎的病例.患者,男,35岁,因乏力、发热、呕吐及上腹部持续性疼痛而急症住院.入院前曾服抗结核药14天(每日利福平600mg,异烟肼300mg,吡嗪酰胺1500mg).否认有饮酒、腹外伤史及脂试验异常,否认膀胱及胰脏疾病史.无糖尿病、脂异常和胰腺炎家族史.发病前未用其他药物,发病后曾服数片布洛芬止痛但未奏效.体检:症状急,呕吐频繁,体温39℃,腹部膨胀,深触诊时上腹部疼痛.此外尚有反跳性病,肌紧张,无肠鸣音等.实验室检查示血浆淀粉酶12.6μkat/L(758μ/L),白细胞16×10~9/L,血糖14Omg/dL,血细胞比容0.35,钙1.85mmol/L,血钾3.0mmol/L.超声及CT检查结果符合急性胰腺炎诊断,胆道正常.临床印象为药源性胰腺炎,疑为利福平所致.患者5天后康复出院.实验指标检查恢复正常.此后患者单独取用异烟肼300mg,6小时后于睡眠中疼醒,上腹剧疼射及背部,伴恶心呕吐.腹部肿胀,剧烈触痛并于上腹部反跳痛.血浆淀粉酶10.3μkat/L(620μ/L),脂酶58.1μkat/L(3488μ/L).痛逐渐消退住院8天后出院.随后患者服利福平、吡嗪酰胺、乙胺丁醇等无任何临床症状.
This is the first record of 1 case of acute pancreatitis caused by isoniazid.Patients, male, 35 years old, hospitalized for acute illness due to fatigue, fever, vomiting and persistent pain in upper abdomen. Daily rifampicin 600mg, isoniazid 300mg, pyrazinamide 1500mg). Denied alcoholism, abdominal trauma and fat test abnormalities, denied a history of bladder and pancreatic disease. No family history of diabetes, lipid abnormalities and pancreatitis. No other drugs before, after taking a few tablets of Ibuprofen analgesic but did not work. Physical examination: the symptoms of acute vomiting, temperature 39 ℃, abdominal distension, deep palpation when the upper abdominal pain. In addition there are still rebound sexually transmitted diseases, Muscle tension, no bowel sounds, etc. Laboratory tests showed plasma amylase 12.6μkat / L (758μ / L), leukocytes 16 × 10 ~ 9 / L, blood glucose 14Omg / dL, hematocrit 0.35, calcium 1.85mmol / L , Serum potassium 3.0mmol / L. Ultrasound and CT findings in line with the diagnosis of acute pancreatitis, biliary normal clinical implication of drug-induced pancreatitis, suspected of rifampin caused by the patient recovered after 5 days of recovery of experimental indicators returned to normal .After this, the patient took isoniazid 300 mg alone, awakened from sleep after 6 hours, ached on the abdomen and back, accompanied by evil Vomiting, swelling of the abdomen, severe tenderness and rebound pain in the upper abdomen.Plasma amylase 10.3μkat / L (620μ / L) and lipase 58.1μkat / L (3488μ / L) Patients taking rifampin, pyrazinamide, ethambutol without any clinical symptoms.