Imai Noboru, Yagi Nobuyasu, Konishi Takashi, Serizawa Masahiro, Kobari Masahiro
Department of Neurology, Shizuoka Red Cross Hospital, Shizuoka.
Intern Med. 2010;49(4):335-8. doi: 10.2169/internalmedicine.49.2704. Epub 2010 Feb 15.
Methylephedrine is generally harmless and is contained in many cough and cold preparations. Likewise, Chinese herbal drugs are considered to be effective and to have few side effects. A 32-year-old woman experienced ischemic stroke attributed to concomitant administration of a cough and cold preparation containing methylephedrine and a supplement containing Chinese herbal drugs. Computed tomography and magnetic resonance imaging of the brain showed acute infarctions bilaterally in the cerebellum. Conventional angiography and magnetic resonance angiography showed transient stenosis of the left vertebral artery. These findings suggested vasospasm or dissection, presumably related to hypertension and/or angiitis or vasoconstriction of large cerebral arteries leading to local thrombosis as a result of stasis and sympathomimetic-induced platelet activation. Combining methylephedrine and Chinese herbal drugs might carry a risk of stroke.
甲基麻黄碱一般无害，许多止咳和感冒药中都含有该成分。同样，中草药被认为疗效显著且副作用较少。一名32岁女性因同时服用含有甲基麻黄碱的止咳感冒药和一种含中草药的补充剂而发生缺血性中风。脑部计算机断层扫描和磁共振成像显示双侧小脑急性梗死。传统血管造影和磁共振血管造影显示左椎动脉短暂狭窄。这些发现提示血管痉挛或夹层，可能与高血压和/或血管炎或大脑大动脉血管收缩有关，导致局部血栓形成，原因是血流淤滞和拟交感神经药诱导的血小板活化。甲基麻黄碱与中草药合用可能有中风风险。
