王宏彦 任丛丛 王庆波 李纪尧 徐晓艳

[摘要]报告1例静脉输注注射用倍他米松磷酸钠引起过敏性休克的病例。本研究通过对1例使用倍他米松磷酸钠减轻手术部位水肿，致过敏性休克的住院患者病例进行分析，提示医务人员糖皮质激素在具有抗过敏、抗休克的同时也存在过敏性休克的不良反应。通过文献学习，对过敏反应发生机制、过敏性休克发病机制、首选药物及其抢救措施进行讨论，警戒临床合理使用糖皮质激素类药物，规范技术操作规章程序，密切监测药物不良反应，及时采取正确的抢救措施，避免造成严重后果。

[关键词]倍他米松;过敏性休克;糖皮质激素;肾上腺素;过敏;不良反应

[中图分类号]R979.5  [文献标识码] A   [文章编号]2095-0616（2021）24-0229-05

A case report of anaphylactic shock caused by betamethasonesodium phosphate

WANGHongyan1 RENCongcong2 WANGQingbo3 LIJiyao1 XUXiaoyan

1. Department of Pharmacy， Brain Hospital of Liaocheng People's Hospital， Shandong， Liaocheng 252000， China;2. Clinical Pharmacy Section， Department of Pharmacy， Liaocheng People's Hospital， Shandong， Liaocheng 252000， China;3. Department of Neurosurgery， Liaocheng People's Hospital， Shandong， Liaocheng 252000， China

[Abstract] A case of anaphylactic shock caused by intravenous infusion of betamethasone sodium phosphate for injection was reported. A case of an inpatient who used betamethasone sodium phosphate to relieve edema at the surgical site and cause anaphylactic shock was analyzed in this paper. And it was suggested that glucocorticoid has effect of anti-allergy and anti-shock， and it also has adverse reactions of anaphylactic shock. Through literature study， the mechanism of allergic reaction， the pathogenesis of anaphylactic shock， the first choice of drugs and rescue measures were discussed， so as to alert the rational use of glucocorticoid drugs in clinic， standardize technical operation procedures， closely monitor adverse drug reactions， and take correct rescue measures in time to avoid serious consequences.

[Key words] Betamethasone; Anaphylactic shock; Glucocorticoid; Adrenaline; Allergy; Adverse reactions

糖皮質激素属于肾上腺皮质激素类药物，应用于临床各科多种疾病的诊断和治疗，具有广泛的生理和药理效应，生理剂量的糖皮质激素影响糖、蛋白质、脂肪及水和电解质代谢，表现为促进糖原异生;减慢葡萄糖分解;减少机体组织对葡萄糖的利用;促进蛋白质分解，造成负氮平衡;促使皮下脂肪分解和脂肪的重新分布，导致向心性肥胖;调节钾、钠和水的代谢，维持机体内外环境平衡。药理剂量的糖皮质激素，具有抗炎、抗过敏、抗休克、免疫抑制、抗细菌内毒素以及对消化系统、血液与造血系统、骨骼和中枢神经系统的作用等[1]。然而该类药品不良反应非常多，特别是长期全身应用过程中或停用后，会产生影响全身各个系统的广泛甚至严重不良反应[2]。……