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作者于1991年7月遇1例服用异烟肼致双侧中毒性视神经病,现介绍如下.患者徐某,女,64岁,住院号36467.1991年7月11日因患“左颈淋巴结结核”,收入外科拟手术摘除.入院后即用异烟肼0.1每日3次口服,链霉素0.5肌注每日2次.7月9日开始觉双眼视物模糊,伴双眼酸胀不适,转来眼科会诊.查视力右0.1,左0.2,不能矫正;而体轻度皮质性浑浊,眼底:视乳头边界清,色正常,视网膜色正常,色觉:绿色盲.周边视野:双侧均有10°～30°向心性缩小.血压16.0/10.0kPa(1kPa=7.5mmHg).体温:37.0℃,实验室检查:血全计(一);尿常规(一); 血沉20mm/h.诊断为异烟肼中毒性视神经病变.建议外科停用异烟肼,改用利福平并给维生素B_1、B_2等肌注,地巴唑口服.7月16日检查视力右0.1,左0.1,余同前.7月18日作“颈淋巴肿块摘除术”,病检:“颈淋巴结结核.”7月27日出院后继续抗痨治疗但不用异烟肼及乙胺丁醇.至
The author in July 1991 case of 1 case of isoniazid induced bilateral toxic optic neuropathy, are described below.Xu, female, 64 years old, hospitalization 36467. July 11, 1991 due to suffering from “left cervical lymph node tuberculosis” , The income of surgery to be surgically removed after admission with isoniazid 0.1 orally 3 times a day, streptomycin 0.5 intramuscular injection twice daily .7 9 began to feel binocular blurred vision, with binge soreness, turn To visual attention right 0.1, left 0.2, can not be corrected; and mild cortical turbidity, fundus: clear papilla border, normal color, normal retinal color, color vision: green blind. Peripheral field of vision: both sides have 10 ° ~ 30 ° concentric contraction. Blood pressure 16.0 / 10.0kPa (1kPa = 7.5mmHg). Body temperature: 37.0 ℃, laboratory tests: total blood (a); urinary routine (a); ESR 20mm / h. Tobacco poisoning optic neuropathy, it is recommended surgical suspension of isoniazid, switch to rifampicin and to vitamin B_1, B_2 and other intramuscular injection of methimazole oral July 16 check visual acuity right 0.1, left 0.1, Yu Tongqian July 18 for “cervical lymphadenectomy”, disease detection: “cervical lymph node tuberculosis.” July 27 after the resumption of anti-tuberculosis treatment but without isoniazid and ethambutol to