葛根素注射液致溶血反应16例文献调查

目的:分析葛根素注射液致溶血反应发生的特点。方法:对1999-2003年国内文献报道的葛根素致溶血反应16例病例进行分析。结果:16例中男性12例,女性4例,≥60岁者10例(2例未报道年龄)。患者用药量200～600mg,1次/d。溶血反应多发生于首次用药3～10d,仅有3例(18.75%)是再次用药发生,既往有无药物过敏史均有可能发生溶血反应。临床以急性溶血性贫血为主要表现,如腰腿关节及全身疼痛,寒战发热,肉眼血尿或尿呈酱油色、浓茶色,实验室检查阳性指标有血RBC、Hb降低,尿中出现血红蛋白(尿潜血阳性)及红细胞。血免疫学检查可见葛根素特异性抗体。结论:葛根素注射液致溶血反应发生与多种因素有关,使用时应高度重视。

Literature review of puerarin-induced hemolysis in 16 cases

Objective: To analyse the characteristics of hemolysis induced by puerarin injection. Methods: From domestic medical journals 1999-2003,16 hemolysis cases due to puerarin were collected and analysed. Results: These 16 cases comprised 12 males and 4 females, mostly over 60 years old. The dose of puerarin was 200 to 600 mg once daily and hemolysis occurred chiefly within 3-10 days of the first couse of treatment except 3 cases occurring during its re-administration. It seemed to be no difference to patients with or without a history of allergy. The main symptoms were arthralgia,generalized pain, rigor, fever and macroscopic hematuria. Hemoglobin in blood was reduced and hemoglobinuria was observed. The specific antibody for puerarin was detected with immunological test. Conclusion: Puerarin-induced hemolysis was related to many factors. Much attention should be paid in the clinical use of puerarin injection.