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自1968年应用SMZ-TMP以来,已报道此药的许多副作用,大部份累及皮肤、造血系统、胃肠道和肾脏,引起心脏毒性者罕见.作者报道一例患者口服SMZ-TMP后二次出现Q-T延长及扭转型室速.患者女性,90岁,既往体健.因恶心、眩晕伴室性心律失常入院.因出现短阵多形室速给予利多卡因,无效;随之静注溴苄胺,终止了心律失常.追询病史,在出现上述症状4小时前曾因脓尿服用Bactrim-Dc(含SMZ 800mg,TMP160mg)一片.未服其他药物,否认心脏病史.体检无异常,ECG示QT及QTc延长,血钾、镁、钙正常.二个月后,又因脓尿口服SMZ-TMP,第一次服药后立即出现恶心、头晕,ECG证实Q-T延长,U波明显伴频发扭转型室速,
Since the application of SMZ-TMP in 1968, many of the side effects of this drug have been reported, most of which involve the skin, the hematopoietic system, the gastrointestinal tract and the kidneys, and are rare in patients with cardiotoxicity.2 The authors reported a second case of SMZ-TMP QT prolongation and torsades de pointes. Female, 90 years old, previously healthy. Admitted to hospital due to nausea, dizziness and ventricular arrhythmias. Lidocaine was ineffective due to short stature pleomorphic VT; followed by intravenous injection of benzyl bromide Amine, termination of arrhythmia .Finish history, in the emergence of the above symptoms 4 hours ago due to pyuria with Bactrim-Dc (SMZ 800mg, TMP160mg) a. No other drugs, denied a history of heart disease. Physical examination was normal, ECG showed QT And QTc prolonged, serum potassium, magnesium and calcium normal two months later, due to pyuria oral SMZ-TMP, the first medication immediately after nausea, dizziness, ECG confirmed QT prolonged, U wave was significantly associated with frequent torsion chamber speed,