西地那非（伟哥®）中毒致多发性脑梗死和横纹肌溶解症：1 例报告。

Multiple Cerebral Infarctions and Rhabdomyolysis After Sildenafil Citrate (Viagra®) Intoxication: A Case Report.

机构信息

Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea.

Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea; Department of Emergency Medicine, Armed Forces Yangju Hospital, Yangju, Republic of Korea.

出版信息

J Emerg Med. 2023 May;64(5):624-627. doi: 10.1016/j.jemermed.2023.02.007. Epub 2023 Mar 22.

DOI:10.1016/j.jemermed.2023.02.007

PMID:37032204

Abstract

BACKGROUND

Sildenafil citrate (Viagra®) is used to treat male erectile dysfunction; however, little is known about the effects of sildenafil overdose and intoxication. We report a patient who presented with cerebral infarction and rhabdomyolysis after intentional sildenafil intoxication.

CASE REPORT

A 61-year-old man visited the Emergency Department complaining of dysarthria about 1 h after taking more than 30 sildenafil tablets with the intention to commit suicide. Dysarthria and dizziness were observed, but there were no other neurological symptoms. The creatine kinase level was elevated to 3118 U/L, and the patient was diagnosed with rhabdomyolysis. Brain magnetic resonance imaging revealed multiple scattered acute cerebral infarctions in both midbrain artery branches. At 4 h post-intoxication, the dysarthria had improved and we initiated dual antiplatelet therapy for cerebral infarction. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be able to anticipate and treat complications like cerebral infarction and rhabdomyolysis after sildenafil intoxication.

摘要

背景

枸橼酸西地那非（伟哥®）用于治疗男性勃起功能障碍；然而，关于西地那非过量和中毒的影响知之甚少。我们报告了一例因故意西地那非中毒导致脑梗死和横纹肌溶解症的患者。

病例报告

一名 61 岁男性因服 30 多片西地那非片企图自杀后 1 小时就诊于急诊，诉构音障碍。观察到构音障碍和头晕，但无其他神经系统症状。肌酸激酶水平升高至 3118 U/L，患者被诊断为横纹肌溶解症。脑磁共振成像显示中脑动脉分支多处散在急性脑梗死。中毒后 4 小时，构音障碍改善，我们开始针对脑梗死进行双联抗血小板治疗。

为什么急诊医生应该注意这一点？：急诊医生应该能够预测和治疗西地那非中毒后的脑梗死和横纹肌溶解等并发症。