2022 年第 9 期 第 17 卷

β内酰胺类抗菌药物导致过敏性休克合并横纹肌溶解综合征1例

A case report of anaphylactic shock complicated with rhabdomyolysis caused by β-lactam antibiotics

作者：董伟邢燕史长松

英文作者：Dong Wei Xing Yan Shi Changsong

单位：河南省人民医院儿童重症监护室，郑州450003

英文单位：Pediatric Intensive Care Unit Henan Provincial People′s Hospital Zhengzhou 450003 China

关键词：过敏性休克；横纹肌溶解综合征；头孢克洛；阿莫西林

英文关键词：Anaphylacticshock;Rhabdomyolysis;Cefaclor;Amoxicillin

• 摘要：

• 1例发热患儿因先后服用头孢克洛、阿莫西林后出现过敏性休克合并横纹肌溶解综合征，分析其原因可能是肌肉缺血、缺血再灌注损伤、自由基损伤、炎症介质介导、细胞内钙超载导致的。针对横纹肌溶解发生机制，早期应积极抗感染治疗，同时需给予抗过敏、改善血管内皮、减轻炎症介质损伤等对症治疗。因此为避免严重过敏事件的发生，临床应用口服或者针剂β内酰胺类抗菌药物前都应严格进行皮试，以预防过敏性休克等严重不良反应发生。

• One febrile child developed anaphylactic shock complicated with rhabdomyolysis after taking cefaclor and amoxicillin, which may be caused by muscle ischemia, ischemia-reperfusion injury, free radical injury, inflammatory mediators and intracellular calcium overload. In view of the mechanism of rhabdomyolysis, active anti-infective treatment should be given in the early stage, and symptomatic treatment should be given at the same time, such as anti-allergy, improving vascular endothelium and reducing the injury of inflammatory mediators. Therefore, in order to avoid the occurrence of serious allergic events, strict skin tests should be carried out before oral administration or injection of β-lactam antibiotics to prevent serious adverse reactions such as anaphylactic shock.