卡托普利引起剧咳误诊为急性支气管炎一例报告

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患者 男,65岁。患高血压病5年,经常服用心痛定、复方降压片等药治疗。无咳喘病史。于1993年10月8日停服其它降压药,改服卡托普利(巯甲丙脯酸)25mg每日3次,1周后出现干咳、夜间加重。查体:心脏无杂音,两肺无干湿性啰音。胸透两肺纹理稍增多,诊为急性支气管炎。给以青霉素80万U,每日2次肌注,复方甘草合剂10ml/日3次口服,继服卡托普利。用药7天无效,咳嗽逐渐加重,出现剧烈干咳,影响休息及睡眠。胸片示两肺纹理稍增多,余无异常。胸部CT未见异常。此时考虑患者剧烈干咳可能为卡托普利所引起。嘱停用该药,停用抗生素及止咳药。干咳逐渐减轻,5天后完全消失。半个月后再次服用卡托普利1周,又出现轻度干咳.停药后症状消失。 Male patient, 65 years old. Hypertension 5 years, often taking heartache, compound antihypertensive tablets and other drugs. No history of cough and asthma. On October 8, 1993 to stop taking other antihypertensive drugs to change captopril (captopril) 25mg 3 times a day, 1 week after the emergence of dry cough, aggravated at night. Physical examination: no heart murmur, dry and wet rales of both lungs. Chest through two lungs slightly increased, diagnosed as acute bronchitis. To penicillin 800,000 U, 2 times a day intramuscular injection of compound licorice mixture 10ml / day orally 3 times, followed by captopril. Medication invalid for 7 days, cough gradually increased, severe dry cough, affecting rest and sleep. Chest radiograph showed slightly increased lung texture, I no abnormalities. Chest CT no abnormalities. At this point consider patients with severe dry cough may be caused by captopril. Told the drug, disable antibiotics and cough medicine. Dry cough gradually reduced, completely disappeared after 5 days. Half a month after taking captopril again for 1 week, and mild dry cough. After stopping the symptoms disappear.
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