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1例24岁男性继发性高血压病患者,为排除原发性醛固酮增多症而接受螺内酯的诊断性治疗,分别于午餐后、晚餐后、次日清晨口服螺内酯各20 mg。第1次服药后约3 h患者突然出现四肢乏力、眩晕、头痛,经卧床休息和吸氧,约30 min后症状缓解。第2次服药后3 h出现乏力。第3次服药后约2 h上述症状复现并伴嗜睡,2 h后自行缓解。停用螺内酯。5 d后患者于晚餐后口服螺内酯20 mg,服药后约2 h以及次日清晨再现眩晕、乏力及嗜睡,后自行缓解。
One 24-year-old male patient with secondary hypertension received diagnostic therapy for spironolactone to rule out primary aldosteronism. Spirolactone was given at 20 mg daily after lunch and at supper the next morning. Approximately 3 hours after the first dose, the patient suddenly developed limb weakness, dizziness and headache. After bed rest and oxygen inhalation, the symptoms were relieved in about 30 minutes. 3h after the second medication appeared fatigue. About 2 h after the third dose, the above symptoms were recovered and accompanied by lethargy, and relieved spontaneously after 2 hours. Spironolactone discontinued. After 5 days, the patients took spironolactone 20 mg orally after dinner, dizziness, fatigue and drowsiness were recovered about 2 hours after taking the medicine and the next morning.