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患者,女,40岁,住院号84438.因胆囊切除手术输血600mL,术后6周出现尿黄、食欲不振,于1993年7月1日入院.化验肝功能ALT208μ,SB<17.1μmol/L,抗HCV(+),诊断为丙型肝炎.经一般保肝治疗肝功能恢复后,7月21日开始加用胸腺因子D(福州金山制药厂产品,批号920227)50mg/d加入10%葡萄糖液250mL中静脉滴注.当天输液完毕时自觉鼻塞、流涕、畏寒,测体温37.5℃(当天基础体温36.8℃),继之头昏、头痛,双下肢酸困、恶心,井呕吐一次.未做处理,至晚9时体温下降至正常,一般状况随之好转,唯睡眠较差.自以为输液过程中受凉感冒,未加注意.次日继续用药,当滴入约60mL时,无诱因出现恶心,喷嚏,滴至100mL时畏寒、四肢酸困,测体温升至37.4℃,P92次/分,BP14/10kPa,WBC4×10~9/L,N70%,E6%(入院时1%).遂疑为药物过敏反应,立即停药,口服消炎痛25mg,2小时后症状消失,体温正常.第3日停止输液,上述症状未再出现.第4日征得病人及家属同意后取胸腺因子D注射液0.1mL于右前臂皮下注射做过敏试验,10分钟后局部潮红、浸润渐增大至2cm直径,20分钟扩增至5cm,伴局部皮肤发痒感,约持续1小时左右逐渐隐退.由此确定为胸腺因子D过敏,详问病史,自述幼年应用青霉素和磺胺药物时曾出现过药物疹.停药后观察3天,痊愈出院.
The patient, female, 40 years old, hospital number 84438. Transfusion of 600 mL after cholecystectomy, urinary yellow 6 weeks after surgery, loss of appetite, admitted to hospital on July 1, 1993. Liver function ALT208μ, SB <17.1μmol / L, Anti-HCV (+), diagnosed as hepatitis C. After the general liver protection liver function recovery, began July 21 plus thymidine D (Fuzhou Jinshan Pharmaceutical Factory, lot number 920227) 50mg / d was added 10% glucose solution 250mL intravenous infusion. The same day the infusion is completed when the nasal obstruction, runny nose, chills, measuring body temperature 37.5 ℃ (day basal body temperature 36.8 ℃), followed by dizziness, headache, double limbs acid trapped, nausea, well vomiting once Do treatment, the body temperature dropped to normal at 9 o’clock at night, the general condition then improved, the only sleep is poor .Since the infusion of cold in the process, did not pay attention .Date of continued medication the next day, when about 60mL drop, no incentive Nausea, sneezing, dripping to 100mL when chills, limbs acid sleepy, measured body temperature rose to 37.4 ℃, P92 / min, BP14 / 10kPa, WBC4 × 10 ~ 9 / L, N70%, E6% Suspected to be allergic to the drug, immediate withdrawal, oral indomethacin 25mg, 2 hours after the symptoms disappeared, body temperature normal infusion stopped on the third day, the above symptoms did not recur. People and their families agree to take 0.1mL thymus D injection in the right forearm subcutaneous injection of allergic tests, 10 minutes after the local flushing, infiltration increased to 2cm diameter, 20 minutes to 5cm, with partial skin itching, About 1 hour continued to gradually retreat.Therefore, to determine the allergy to thymus D, detailed medical history, a report of childhood penicillin and sulfa drugs drug rash occurred during the withdrawal observed 3 days, discharged.