曲马多诱导的低血糖的临床特征分析
Analysis of clinical characteristics of tramadol induced hypoglycemia
刘伟 1何琴 1何怡然1
作者信息
- 1. 湖南中医药大学第一附属医院药学部,长沙 410007,湖南
- 折叠
摘要
目的:探讨曲马多诱导的低血糖的临床特点.方法:通过检索中英文数据从建库起至2023年4月28日,收集曲马多诱导的低血糖的病例报告.结果:20例患者被纳入,中位年龄为50岁(4,88).低血糖发生在给药后1h～23d,血糖的中位值为2.25 mmol/L(0.22,3.3),曲马多的中位日剂量为300 mg(1.53,14 000).临床主要表现为昏迷(12例),多器官功能衰竭(7例),心肺骤停(7例),癫痫发作(4例),嗜睡(3例)和出汗(3例)等.6例患者报告了曲马多血药浓度,中位值为3.56 mg/L(0.47,9.4).20例患者停用曲马多,给予对症支持治疗后,16例患者恢复,1例患者中度脑功能障碍,3例患者死亡.结论:曲马多诱导的低血糖可发生在给药后1 h～23 d,临床可表现为自主神经系统症状和神经低血糖症状,以神经低血糖症状为主.停用曲马多后大部分患者低血糖可恢复正常,严重者可死亡.
Abstract
AIM:To investigate the clinical charac-teristics of tramadol-induced hypoglycemia.METH-ODS:Case reports of tramadol-induced hypoglyce-mia were collected by searching Chinese and Eng-lish data from the database establishment to April 28,2023.RESULTS:Twenty patients were included,with a median age of 50 years(4,88).Hypoglyce-mia occurred 1 h-23 d after tramadol administra-tion,with a median blood glucose of 2.25 mmol/L(0.22,3.3)and a median daily dose of 300 mg(1.53,14 000).The main clinical manifestations were unconscious(12 cases),multiple organ failure(7 cases),asystole and/or apnea(7 cases),seizures(4 cases),somnolence(3 cases)and sweating(3 cases).Tramadol concentrations were reported in 6 patients,with a median of 3.56 mg/L(0.47,9.4).Af-ter stopping tramadol in 20 patients and giving symptomatic supportive treatment,16 patients re-covered,1 patient had moderate brain dysfunction,and 3 patients died.CONCLUSION:Tramadol in-duced hypoglycemia can occur from 1 h to 23 d af-ter administration,and can be clinically manifested as autonomic nervous system symptoms and neu-rohypoglycemia symptoms,mainly neurohypoglyce-mia symptoms.After stopping tramadol,most pa-tients with hypoglycemia returned to normal,and severe patients can die.
关键词
曲马多/低血糖/止痛药/阿片类/不良反应Key words
tramadol/hypoglycemia/analgesics/opioid/adverse drug reactions引用本文复制引用
基金项目
湖南中医药大学科研项目(2019XJJJ055)
出版年
2024
国家科技期刊平台
NSTL
万方数据