替比夫定相关致命性乳酸酸中毒并多器官功能障碍综合征1例
Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences（2019）
Abstract
替比夫定相关不良反应报道逐渐增多,较常见的有肌酶及乳酸水平升高.中南大学湘雅医院收治1例长期口服替比夫定的23岁男性患者,临床主要表现为进行性肌痛,逐渐进展至神志障碍,同时合并多器官功能障碍,其中乳酸水平明显升高,代谢性酸中毒极为严重,病情凶险,诊断为替比夫定所致罕见严重不良反应.给予血液净化、碳酸氢钠纠正酸中毒,头孢他啶抗感染,停用替比夫定,改用替诺福韦二吡呋酯并护肝等治疗,患者病情好转出院.此类患者早期极易误诊为神经肌肉系统疾病,延误治疗,导致病情恶化,临床医生需提高警惕,早期识别,避免误诊.
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Key words
Neural Tube Defects
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