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复发性血栓性微血管病与静脉注射缓释羟考酮

Relapsing thrombotic microangiopathy and intravenous sustained-release oxycodone.

作者信息

Nataatmadja Melissa, Divi Dakshinamurthy

机构信息

Department of Nephrology , Gold Coast University Hospital , Southport, QLD , Australia.

出版信息

Clin Kidney J. 2016 Aug;9(4):580-2. doi: 10.1093/ckj/sfw039. Epub 2016 May 30.

DOI:10.1093/ckj/sfw039
PMID:27478601
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4957719/
Abstract

Thrombotic microangiopathy (TMA) associated with injecting sustained-release oxymorphone, an opioid intended for oral use, has previously been reported. We report a case of TMA secondary to intravenous use of sustained-release oxycodone, and the first case to demonstrate relapsing disease due to persistent intravenous opioid use. In cases such as these, TMA is suspected to be due to a polyethylene oxide (PEO) coating found on these drugs, and the disease is likely due to a directly toxic effect of PEO to endothelial cells. We hypothesize that there are unidentified genetic predispositions causing some persons to be susceptible to developing this disease.

摘要

此前已有报道，与注射用于口服的阿片类药物缓释羟吗啡酮相关的血栓性微血管病（TMA）。我们报告一例因静脉使用缓释羟考酮继发的TMA病例，这也是首例因持续静脉使用阿片类药物而出现疾病复发的病例。在这类病例中，TMA被怀疑是由于这些药物上发现的聚环氧乙烷（PEO）涂层所致，该病可能是由于PEO对内皮细胞的直接毒性作用。我们推测，存在一些未被识别的遗传易感性因素，导致一些人易患此病。

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本文引用的文献

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2
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Resurgence of intravenous Opana as a cause of secondary thrombotic thrombocytopenic purpura.静脉注射奥施康定再度成为继发性血栓性血小板减少性紫癜的病因。
Am J Emerg Med. 2014 Aug;32(8):951.e3-4. doi: 10.1016/j.ajem.2014.01.058. Epub 2014 Feb 7.
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Opana ER abuse and thrombotic thrombocytopenic purpura (TTP)-like illness: a rising risk factor in illicit drug users.奥施康定缓释片滥用与血栓性血小板减少性紫癜（TTP）样疾病：非法药物使用者中日益增加的风险因素。
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