药物过敏导致Ⅰ型Kounis综合征1例

杨昌林; 曹淑风; 乔莲; 赵慧敏

doi:10.16766/j.cnki.issn.1674-4152.003273

药物过敏导致Ⅰ型Kounis综合征1例

doi: 10.16766/j.cnki.issn.1674-4152.003273

中国人民解放军联勤保障部队第970医院全科医学科，山东烟台 264000

详细信息

通讯作者:
曹淑风, E-mail: csf1004@126.com

中图分类号: R541.9
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出版历程
- 收稿日期: 2023-02-09
- 网络出版日期: 2024-01-13

A case of type Ⅰ Kounis syndrome caused by drug allergy

Department of General Practice, 970 Hospital of the PLA JLSF, Yantai, Shandong 264000, China

摘要

摘要: Kounis综合征是继发于过敏反应的冠状动脉痉挛甚至急性心肌梗死的综合征。本例高龄患者因社区获得性肺炎住院治疗，使用哌拉西林钠他唑巴坦钠抗感染治疗时发生迟发性过敏反应，抗过敏治疗好转，但出现胸闷、憋气症状，行心电图示下壁导联典型弓背抬高且呈动态改变，心肌酶正常，急至导管室行冠脉造影提示右冠冠脉痉挛，给予硝酸甘油局部注射痉挛消失，此病例为Ⅰ型Kounis综合征。Kounis综合征在临床并不多见，易造成漏诊、误诊，早期识别并妥善治疗是改善临床预后的关键。
- 哌拉西林钠他唑巴坦钠过敏 /
- Kounis综合征 /
- 冠状动脉痉挛
Abstract: Kounis syndrome is a syndrome of coronary artery spasm and even acute myocardial infarction secondary to anaphylaxis. The elderly patient in this case developed delayed anaphylaxis when using piperacillin sodium and tazobactam sodium for anti-infective treatment of community-acquired pneumonia in hospital, and the antiallergic treatment improved, but the symptoms of chest tightness and breathlessness occurred, the typical arched back of the inferior wall lead is elevated and dynamic on the electrocardiograph, and the myocardial enzyme is normal. Coronary angiography is performed immediately in the catheter room, which shows a spasm of the right coronary artery, and the spasm disappears after local injection of nitroglycerine. This case is type Ⅰ Kounis syndrome. Kounis syndrome is rare in clinical practice, which can easily lead to missed diagnosis and misdiagnosis. Early recognition and appropriate treatment is the key to improving the clinical prognosis.
- Allergy to piperacillin sodium and tazobactam sodium /
- Kounis syndrome /
- Coronary artery spasm

HTML全文

图 1 患者胸闷憋气发作时心电图表现

注：图示ST-T呈动态改变。

Figure 1. ECG manifestations of patient with chest tightness and suffocation

下载: 全尺寸图片幻灯片

图 2 右冠脉痉挛及注射硝酸甘油后痉挛消失

Figure 2. Right coronary artery spasm and disappearance of spasm after nitroglycerin injection

下载: 全尺寸图片幻灯片

图 3 患者胸闷憋气缓解后心电图表现

Figure 3. ECG manifestations of patient after relief of chest tightness and suffocation

下载: 全尺寸图片幻灯片

参考文献(16)

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