碘帕醇注射液引起感应神经性耳聋1例

碘帕醇注射液（商品名碘比乐,IopamidolInjection,）是非离子型水溶性碘造影剂,常用于CT检查中增强扫描。CT增强扫描的浓度为300—370mg／ml,推荐剂量为0．5—2．0ml／蚝。常见不良反应为恶心、呕吐、皮疹、发热和出汗,极少数病人可能有过敏性喉头水肿和药物性休克发生。突发性耳聋鲜有报道,本文报道1例由碘帕醇注射液行肺部CT增强扫描所致特发性耳聋。望引起同道重视。     

碘佛醇致对比剂脑病一例

对比剂脑病是在血管内使用对比剂后出现的一种罕见的神经系统并发症,经过及时的诊断和治疗,患者一般预后良好,但亦有部分患者预后不良.该文报道1例应用碘佛醇行全脑血管造影术后即刻出现小脑功能障碍的对比剂脑病病例,以期对对比剂脑病的诊治提供一定的临床指导.     

体外膜肺氧合成功抢救碘帕醇对比剂致过敏性休克1例的体会

<正>患者男,50岁。2013年10月15日凌晨突发胸痛,位于胸骨后,压榨性,程度重,伴出汗、恶心、呕吐。起病4 h后至我院急诊室,仍持续胸痛未减轻,18导联心电图检查后,诊断"急性ST段抬高型下壁、正后壁、右室心肌梗死",心脏超声提示"左室下后壁运动减低(室间隔厚度1.2 cm)"。在急诊室反复发作室颤4次,予电除颤转复,建议行急诊冠状动脉介入治疗,患方因个人原因拒绝。既往有2型糖     

酒精戒断致低钠血症1例

一、病例资料 患者男性,65岁.无明显诱因出现渐进性乏力、腹胀、上腹不适,伴呃逆、食欲下降,偶有恶心,无呕吐,胸闷气短,夜间难以入睡1月余,于2009年2月10日入住沈阳市某医院,行胃镜检查,发现浅表性胃炎,结肠镜检查未见异常.血钾(K+)4.7 mmol/L,血钠(Na+)120 mmol/L,血氯(Cl-)89.5 mmol/L.肝、肾功能等生物化学检查均正常.给予高张盐水(3%氯化钠)、营养支持等对症治疗后好转,于3月8日出院.出院后1周,上述症状再次出现并逐渐加重,于4月3日收入本院.     

脑部疾病致低钠血症3例报告

抗利尿激素分泌异常综合征（SIADH）是指体内抗利尿激素（ADH）分泌不受低渗透压或低血容量等抑制因素而分泌异常增多或其活性作用异常,从而导致水潴留以及稀释性低钠血症。SIADH可见于多种疾病,如各种肿瘤（包括胸腺瘤）、肺部各种疾病、脑部疾病以及某些药物等。近年来已有脑部疾病引起的SIADH报道,我们最近遇到3例,现报告如下：     

粗糠柴霉素抑制碘帕醇诱导的大鼠肾小管上皮细胞凋亡

目的研究粗糠柴霉素（Rottlerin）对碘帕醇诱导的大鼠肾小管上皮细胞凋亡的影响,并探讨其机制。方法体外培养的大鼠肾小管上皮细胞（NRK-52E）分别用0．5～2μmol／L的Rottlerin与100mgI／ml碘帕醇共同处理2h,或在碘帕醇处理的同时加入2μmol／LRottlerin处理不同时间,或以2μmol／LRottlerin预处理1h后再用碘帕醇处理2h。以相同渗透浓度的甘露醇处理2h的细胞作为对照。Hoechst33342染色观察凋亡细胞核形态并计算凋亡细胞百分比;以DEVD—AFC为荧光底物测量caspase酶活性;用DCFH—DA荧光探针检测细胞内活性氧（ROS）水平;Westernblot检测PKC-8蛋白表达。结果碘帕醇可诱导NRK-52E细胞PKC-8蛋白表达、细胞内ROS生成、caspase酶激活及细胞凋亡。Rottlerin可抑制以上变化,呈剂量依赖性抑制细胞凋亡,但Rottlerin预处理不能减少细胞凋亡。结论Rottlerin可抑制碘帕醇诱导的NRK-52E细胞凋亡,为造影剂肾病的治疗提供了新药物。     

垂体后叶素致低钠血症性脑病一例

<正>患者,女,43岁,因“咯血2小时”于2020年9月15日入院。患者就诊前约2 h无明显诱因出现咯血,为整口鲜红色,量多约500 ml, 由120救护车送入我院急诊科,完善胸部及头颅CT检查提示两肺支气管扩张伴感染表现,头颅未见明显异常,以“支气管扩张伴咯血”收入我科。期间患者无畏寒、发热、胸闷、气喘、心前区疼痛,饮食及睡眠可,大、小便如常。既往史：支气管扩张病史10余年,10年前曾有过大咯血病史。入院体格检查：T 37.3 ℃,     

胺碘酮致肺损伤一例

患者男,65岁.因"胸闷气促伴咳嗽1个月"于2011年6月23日入院.患者于1个月前无明显诱因下出现胸闷、气促,活动后加重.同时伴有少量咳嗽、咳痰.痰量少、色白、黏稠、不易咳出.伴乏力、体重减轻.无发热、盗汗、胸痛、痰血,也无心悸、夜间阵发性呼吸困难、无双下肢浮肿等症状.外院X线胸片显示双肺斑片状阴影.胸部CT显示双肺弥漫性斑片条索样病灶.经抗感染治疗,病情无明显缓解.复查X线胸片双肺病变未见明显吸收.入院后胸部高分辨率CT示双肺弥漫性病变.发病以来患者食欲差,睡眠尚可,大小便正常.既往健康状况一般,有高血压病史3年,规律服用降压药物.有吸烟史20余年,1998年戒烟.有心律失常2年余,服用胺碘酮1.5年.否认传染病史、过敏史、外伤史、手术史及输血史、无特殊职业接触史.     

胺碘酮致紫癜一例

1　临床资料患者女性 ,6 9岁 ,因冠心病、病态窦房结综合征于 2 0 0 1年 3月安装永久性人工心脏起搏器 (Sigma公司SSR2 0 3)。术后因持续性心房颤动 ,遵医嘱服用胺碘酮 [可达龙 ,杭州赛诺菲 圣德拉堡 民主制药有限公司生产 ,批号 (1999年 )国药准字XF2 0 13号 ]。按常规负荷量疗法服药 ,维持量为 0 .1g ,1次 d。口服胺碘酮后显效 ,偶有阵发性心房颤动发作 ,服药期间定期复查心电图、胸部X线、甲状腺激素、血常规等。同年 6月 3日 ,化验室检查 :红细胞 4.2 3× 10 1 2 L ,白细胞 5 .6 0× 10 9 L ,血小板 140× 10 9 L ,6月 2 2日 ,全身…     

胺碘酮致过敏性休克一例

患者女性,36岁,因室上性心动过速入院,给予胺碘酮静脉泵入,约3 min后出现面部潮红,视物模糊,心前区疼痛,伴皮肤苍白,出汗等症状,伴血压降低。改用普罗帕酮静脉滴注,约2 min,室上性心动过速终止。经补液等处理血压回升。约2 h后患者出现面部浮肿、全身散在皮疹伴瘙痒。考虑为胺碘酮所致休克。     

Hepatotoxicity induced by cyproterone acetate： A report of three cases

INTRODUCTION Androgen deprivation therapy in the form of either orchiectomy or treatment with endogenous estrogens or luteinizing hormone releasing hormone (LHRH) analogues alone or coupled with antiandrogens, produces regression of prostate cancer cells …     

Cutaneous vasculitis induced by TNF inhibitors: a report of three cases

We describe 3 rheumatoid arthritis (RA) patients with anti-tumor necrosis factor (TNF) therapy-induced cutaneous vasculitis. Two cases were induced by infliximab and the other, in whom cutaneous vasculitis was found early at the start of therapy, was induced by etanercept. Skin biopsy was obtained in 2 patients, with histology-proven leukocytoclastic vasculitis. One patient spontaneously improved after cessation of the TNF inhibitor. Two patients required oral corticosteroid, the efficacy of which was observed to be excellent and rapid.     

Propafenone-induced ataxia: report of three cases

Propafenone is an effective antiarrhythmic drug used widely for the treatment of supraventricular and ventricular arrhythmias. Although it is generally well tolerated, 30 to 45% of patients may experience adverse cardiac effects. In 15 to 20% of patients, adverse effects may involve other organ systems. A wide variety of adverse central nervous system effects have been reported in association with propafenone; dizziness is the most common. Ataxia caused by propafenone has been reported to the pharmaceutical companies and drug monitoring agencies, but has not been well described or emphasized in the medical literature. We describe 3 elderly patients with moderate to severe ataxia that occurred while they were taking propafenone.     

Corneal ulcer caused by Pseudomonas pseudomallei: report of three cases

We report three cases of corneal ulcer caused by Pseudomonas pseudomallei. In all cases corneal trauma preceded the development of extensive ulcers, subconjunctival abscesses, and hypopyon. Treatment for a total of 8 weeks with topical and/or parenteral ceftazidime followed by amoxicillin-clavulanic acid produced resolution of infection in each case.     

Snapping scapulae: a report of three cases

Snapping scapula or retroscapular pain is uncommon, and few cases require surgical intervention. In three cases the symptoms were such as to eventually require surgery. No obvious cause was found but excision of the 2 cm of the medial scapular border resulted in prompt and permanent pain relief. Why this should be so is a mystery.     

急性血吸虫病误诊3例

急性血吸虫病症状容易与某些传染病混淆,临床上时有误诊误治,本资料3例误诊时间较长,现就其诊断过程作一分析,以此吸取教训,提高诊断准确率。1临床资料例1男,35岁,农民。因发热、腹痛入院。入院前15天,患者出现发热、右上腹疼痛、腹泻,每日数次,为黏液血便,曾按“菌痢”治疗,疗