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西地那非的使用与吸烟与脑出血有关:罕见病例报告。

Sildenafil Use and Cigarette Smoking Associated with Intracerebral Hemorrhage: A Rare Case Report.

机构信息

Department of Internal Medicine and Intensive Care Unit, Dr. Sumait Hospitals Affiliated of SIMAD University, Mogadishu, Somalia.

Department of Medicine and Surgery of Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia.

出版信息

Vasc Health Risk Manag. 2024 Jan 9;20:21-26. doi: 10.2147/VHRM.S443995. eCollection 2024.

Abstract

BACKGROUND

Intracerebral hemorrhage (ICH) is a serious condition characterized by bleeding within the brain tissue. Although the use of sildenafil, a vasodilator agent for erectile dysfunction, has been associated with rare cases of ICH, the combination of sildenafil usage and smoking as risk factors for ICH has not yet been reported. This case report describes the occurrence of ICH in a patient with a history of both sildenafil usage and heavy smoking.

CASE PRESENTATION

A 53-year-old male, with a history of smoking and regular sildenafil use, was brought to the emergency department due to loss of consciousness with right-side weakness, he initially experienced with nausea, vomiting and dizziness after taking sildenafil 100mg tablet once. The Glasgow Coma Score (GCS) was 10 with side hemiparesis. Non-contrast CT revealed left thalamic acute hemorrhage with ventricular extension. Furthermore, a head CT angiography ruled out any vascular anomalies after that the patient was admitted to the intensive care unit (ICU) for conservative management. After three days on clinical and neurological improvement, the patient was transferred to the inpatient ward for further management, monitoring and physiotherapy. On day 6, the patient was discharged and planned for flow up.

CONCLUSION

This rare case highlights the need for further research and awareness regarding the potential risks associated with the combination of sildenafil and heavy smoking. Healthcare professionals should carefully evaluate the individual risk factors of patients, educate them about potential complications, and consider alternative treatments if necessary. Additionally, patients should be encouraged to quit smoking and adopt a healthy lifestyle to minimize the risk of cerebrovascular events.

摘要

背景

脑出血(ICH)是一种严重的疾病,其特征是脑组织内出血。虽然西地那非(一种用于治疗勃起功能障碍的血管扩张剂)的使用与罕见的 ICH 病例有关,但西地那非使用和吸烟作为 ICH 的风险因素的组合尚未报道。本病例报告描述了一名既有西地那非使用史又有重度吸烟史的患者发生 ICH 的情况。

病例介绍

一名 53 岁男性,有吸烟史和定期使用西地那非,因意识丧失伴右侧无力被送往急诊科,他最初在服用西地那非 100mg 片剂一次后出现恶心、呕吐和头晕。格拉斯哥昏迷评分(GCS)为 10,伴有偏瘫。非对比 CT 显示左丘脑急性出血伴脑室扩展。头部 CT 血管造影进一步排除了任何血管异常,此后患者被收入重症监护病房(ICU)接受保守治疗。在临床和神经改善三天后,患者被转至住院病房进行进一步管理、监测和物理治疗。第 6 天,患者出院并计划进行随访。

结论

这个罕见的病例强调了需要进一步研究和提高对西地那非和重度吸烟组合相关潜在风险的认识。医疗保健专业人员应仔细评估患者的个体风险因素,教育他们潜在的并发症,并在必要时考虑替代治疗。此外,应鼓励患者戒烟并采取健康的生活方式,以最大程度地降低脑血管事件的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5612/10787546/136e05384a4c/VHRM-20-21-g0001.jpg

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