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临床输血与检验

临床输血与检验 ›› 2018, Vol. 20 ›› Issue (1): 10-12.DOI: 10.3969/j.issn.1671-2587.2018.01.004

• 药物性抗体引起免疫性溶血反应专题 • 上一篇    下一篇

头孢哌酮钠舒巴坦钠致药物溶血性贫血的分析

马春娅, 张晓娟, 罗圆圆, 付丽辉, 何春宇, 于洋, 汪德清   

  1. 100853 北京,中国人民解放军总医院输血科
  • 收稿日期:2017-12-21 出版日期:2018-02-20 发布日期:2018-02-28
  • 通讯作者: 汪德清,教授,博士生导师,主要从事临床输血研究,（E-mail）deqingw@vip.sina.com。
  • 作者简介:马春娅（1981-）,女,主管技师,硕士,主要从事临床输血工作,（E-mail）mcydou@163.com。

A Case Report of Cefoperazone-Sulbactam Sodium-induced Hemolytic Anemia

MA Chunya, ZHANG Xiaojuan, LUO Yuanyuan, et al   

  1. Blood Transfusion Department,the PLA General Hospital,Beijing 100853
  • Received:2017-12-21 Online:2018-02-20 Published:2018-02-28

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摘要： 目的 建立针对药物溶血性贫血的诊断流程。方法 应用卡式抗人球蛋白法完成患者红细胞直接抗人球蛋白试验（DAT）及DAT分型检测,应用药物致敏红细胞方法检测患者血浆内的药物抗体,分析患者的溶血及凝血指标。结果 患者DAT阳性,分型为IgG+C3型,血浆内存在针对头孢菌素类药物抗体;患者用药后Hb从122 g/L下降至80 g/L, PLT从90 × 109/L下降至17 × 109/L;LDH从用药前 189.5 μmol/L上升至 347.2 μmol/L,AST 从25.7 U/L上升至63.5 U/L;患者用药后PT从用药前的13.4 s 延长到20.9 s,APTT从35.8 s 最长延长到56.6 s,INR从1.19 延长到1.8。结论 患者因使用头孢哌酮钠舒巴坦钠发生针对血液系统的不良反应,导致药物溶血性贫血。

关键词: 头孢哌酮钠舒巴坦钠, 溶血性贫血, 抗人球蛋白试验, 药物抗体

Abstract: Objective To report one case of hemolytic anemiainducedby cefoperazone-sulbactam sodium, with theestablishment of diagnostic procedure for the patient. Methods The anti-human globulin test and DAT typing of erythrocytes were performed in the patient. The antibodies against the drugs weredetected by drug-sensitized erythrocytes and the hemolytic and coagulation index were analyzed. Results DAT was positive and DAT typingshowed IgG+C3, and antibodies against cephalosporins was present in theserumof the patient, the Hb decreased from 122g / L to 80g / L after treatment and the PLT from 90×109/ L to 17×109/L. Inversely, LDH increased from 189.5 μmol / L to 347.2 μmol / L and AST increased from 25.7 U / L to 63.5 U / L. PT prolonged from 13.4 s to 20.9 s and APTT from 35.8 s to 56.6 s, with the INR extending from 1.19 to 1.8. Conclusion Hemolytic anemiamay occurin the patient following cefoperazone-sulbactam sodium administration.

Key words: Cefoperazone-sulbactam sodium, Hemolytic anemia, Anti-human globulin test, Antibodies against drug

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