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由药物吸附作用机制引起的免疫溶血性贫血,主要见于接受青霉素类和第一代头孢菌素类药物治疗的患者.作者报道1例由静脉给予头孢替坦引起贫血的病人.在该病人血清和红细胞洗脱液中,检出了头孢替坦依赖性抗体.在无头孢替坦存在下,洗脱物也能与红细胞发生微弱的反应,提示伴发温反应性自身抗体的形成.临床观察连同实验室检查,发现有血管外溶血,这些和药物诱发的溶血性贫血一致.其作用机制可能涉及到药物吸附和自身抗体的形成.通过本病例,作者强调要提高对所有头孢菌素诱发溶血反应的认识.
The immune-hemolytic anemia caused by the mechanism of drug adsorption is mainly seen in patients receiving penicillins and first-generation cephalosporins.It was reported that 1 patient was intravenously given cefotetan-induced anemia, In the erythrocyte eluate, a cefotetan-dependent antibody was detected, and in the absence of cefotetan, the eluate also reacted weakly with erythrocytes, suggesting a formation of a thermoreactive autoantibody with clinical observation. Laboratory tests found that extravascular hemolysis, which is consistent with the drug-induced hemolytic anemia.The mechanism may involve drug adsorption and the formation of autoantibodies.Through this case, the authors emphasize the need to improve all the cephalosporin-induced hemolysis Understanding.