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磷酸丙吡胺诱发的急性心力衰竭和肝缺血

Acute cardiac failure and hepatic ischemia induced by disopyramide phosphate.

作者信息

Scheinman S J, Poll D S, Wolfson S

出版信息

Yale J Biol Med. 1980 Sep-Oct;53(5):361-6.

Abstract

Two patients abruptly developed congestive heart failure and elevation in serum transaminase levels when given disopyramide phosphate; enzyme abnormalities and hemodynamic status corrected upon withdrawal of the drug. Both patients had underlying ischemic cardiomyopathy. Myocardial infarction, pulmonary embolism, and viral hepatitis were ruled out in both patients. One patient had a liver biopsy documenting central hepatic necrosis with congestion, consistent with hepatic ischemia and not toxic hepatitis. In the other patient, cardiac decompensation and hepatocellular enzyme elevation were reproduced on rechallenge with the drug. Disopyramide should be used with caution in patients with heart failure.

摘要

两名患者在服用磷酸丙吡胺后突然出现充血性心力衰竭和血清转氨酶水平升高;停药后酶异常和血流动力学状态得到纠正。两名患者均患有潜在的缺血性心肌病。两名患者均排除了心肌梗死、肺栓塞和病毒性肝炎。一名患者进行了肝脏活检,结果显示中央肝坏死伴充血,符合肝缺血而非中毒性肝炎。在另一名患者中,再次使用该药物后再次出现心脏失代偿和肝细胞酶升高。心力衰竭患者应谨慎使用丙吡胺。

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