拜新同所致皮肤损伤的临床特点.docVIP

硝苯地平片所致的临床特点氯雷他定片或acute generalized anthematous pustulosis caused by nifedipine tablets Jin Na Cui Ying Huang Rui Department of Neurology，Shengjing Hospital of China Medical University，Shenyang 110004，China [Abstract] Objective To investigate the Clinical feactures of acute generalized anthematous pustulosis caused by nifedipine tablets，Provide a reference for timely diagnosis and treatment；Methods The clinical data of a patient were analyzed retrospectively on 2014; Reviewed the existing literature；investigate the acute generalized anthematous pustulosis caused by nifedipine tablets. Result there are tow literatures about acute generalized anthematous pustulosis caused by nifedipine tablets. The incubation period is 3 days. The rash can start from the trunk and limbs,Typical characteristic lesions is o non-small follicles (diameter usually 5mm) aseptic pustules generalizedon the edema erythema. Pausing the teblets and anti-allergy drug is the key to the mild patients,severe patients needs glucocorticoids; Prognosis is good. Conclusions acute generalized anthematous pustulosis caused by nifedipine tablets are rare, difficult to identify.but prognosis is good. Key words：acute generalized anthematous pustulosis 0引言 我国18岁及以上居民高血压患病率为18.8%，估计全国患病人数1.6亿多。64岁，以“右上肢麻木1天”为主诉入院。患者2014年4月24日凌晨2点中左右，醒后自觉右上肢肘关节以下麻木，并伴有轻微无力，无头痛、头晕，无恶心呕吐，无视物成双，无饮水呛咳。麻木持续不缓解。行头CT平扫检查200/100mmhg，给予“乌拉地尔注射液”静脉泵入降压，2014年4月25日以“脑出血”收入我科。既往否认高血压、糖尿病、心脏病病史。否认药物及食物过敏史。入院时查体：患者平车推入，P68次/分，BP：180/90mmHg，呼吸：18次/分。心肺听诊未见异常，腹软，无压痛、反跳痛及肌紧张。神经系统：神清，言语尚流利，双瞳孔等大正圆，D=3.0mm，对光反射灵敏，眼球各方向运动不受限，无眼震，面纹对称，鼻唇沟对称，示齿不偏，伸舌居中，张口下颌不偏，转颈耸肩有力。无肌肉萎缩，左侧肢体肌力V级，右上肢远端肌力V级-，右上肢近端肌力V级，四肢肌张力正常。深感觉基本正常，右上肢远段痛觉减退。指鼻及跟膝胫试验稳准。右手轮替差。BCR(L++ R++)，PSR(L++R++)，Babinski sign(L-R-)，颈软。入院后检查：心电图：正常心电图，窦性心律 68bpm。肝功能：谷草转氨酶37U/L. 尿便常规、心肌酶谱、肾功能、凝血五项、血常规、血气未见明显异常。治疗方案：低盐低脂饮食，泮托拉唑钠预防应激性消化道损伤，脑苷肌肽营养修复神经，硝苯地平片30mg日一次口服控制血压；4月27日患者出现背部及下肢大腿根部出现大片红色皮疹，有痒感，皮温高。测体温无发热，化验血常规：白细胞计数10.9*10^9/L，中性粒细胞百分比79.4%，中性粒细胞计数7.25*10^9/L。加用青霉