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患者,男,56岁。平素健康,近10余年来反复哮喘,多在受凉后发病。查体除双肺闻及广泛哮鸣音及肺气肿征外,余无明显阳性体征。为增强机体抵抗力,给予人血丙种球蛋白注射,每次3ml,每周1次。当第3次注射完毕时,患者突感胸闷、咳嗽、气喘,端坐呼吸,面部严重紫绀,大汗淋漓,心悸。呼吸40/min,血压17.3/12.0kPa,心率120/min,心律整齐。双肺满布大量哮鸣音。立即吸氧,皮下注射肾上腺素0.2mg,静脉推注10%葡萄糖20ml加氨茶碱0.25g和地塞米松10mg。约30min后,上述症状逐渐消失,面色恢复正常,呼吸、脉搏、血压平稳,双肺闻及少量哮鸣音。讨论人血丙种球蛋白(普通丙种球蛋白)是从健康人血浆中提取的免疫球蛋白,含蛋白10%,其中丙种球蛋白占90%以上,而其中主要为IgE,能提高
Patient, male, 56 years old. Usually healthy, repeated asthma over the past 10 years, and more in the cold disease. Physical examination in addition to lungs and extensive wheeze heard emphysema syndrome, I no significant positive signs. In order to enhance the body’s immunity, give human blood gamma globulin injection, each 3ml, once a week. When the third injection was completed, the patient suddenly felt chest tightness, coughing, wheezing, sitting and breathing, severe facial cyanosis, sweating, heart palpitations. Breathing 40 / min, blood pressure 17.3 / 12.0kPa, heart rate 120 / min, rhythm and neat. Full lungs covered with a large number of wheeze. Immediate oxygen, subcutaneous injection of epinephrine 0.2mg, intravenous injection of 10% glucose 20ml plus aminophylline 0.25g and dexamethasone 10mg. About 30min, the above symptoms gradually disappear, looking back to normal, breathing, pulse, blood pressure steady, a small amount of wheal heard wheeze. Discussion Human blood gamma globulin (normal gamma globulin) is extracted from healthy human plasma immunoglobulin, containing 10% protein, including gamma globulin accounted for more than 90%, of which mainly IgE, can increase