案例报告:多次电解质干扰与严重的神经症状,由长期使用PPI诱导
Alexander Bertuccioli1,2, Marco Cardinali1,3, Francesco Di Pierro2,4,5
1Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino, Italy.
Frontiers in medicine
|October 3, 2025
概括
长期使用质子抑制剂 (PPI) 可能导致电解质失衡,如低磁血症. 停止服用PPI和其他药物改善了老年患者的症状,并使其电解质水平正常化.
科学领域:
- 老年医学 老年医学
- 临床药理学 临床药理学
- 内部医学 内部医学
背景情况:
- 质子抑制剂 (PPI) 经常被处方,特别是对于有多种健康状况的老年患者.
- 长期使用PPI与不良影响有关,包括低磁血和电解质障碍,可能会影响神经肌肉和认知功能.
- 这些效应往往未被充分认识到,特别是在多种药物治疗的个体中.
研究的目的:
- 介绍一个老年患者的病例研究,该患者经历了长期使用质子抑制剂 (PPI) 治疗引起的严重电解质干扰.
- 突出PPI和抗药对电解质平衡的潜在阳效应.
- 强调定期药物审查在管理老年患者中的重要性.
主要方法:
- 一个84岁男性的病例介绍,他患有多种并发症,长期接受PPI治疗.
- 诊断工作包括实验室测试,揭示了低血,低血和间歇性低磁血.
- 干预涉及全面的药物审查和中止潘托普拉和莱维特拉,因果关系使用Naranjo算法进行评估.
主要成果:
- 患者出现了消化不良,神经肌肉症状和类似发作的发作.
- 尽管服用补充剂,但实验室测试始终显示出电解质异常.
- 在停止服用潘托普拉和莱维西拉后,该患者的临床状况明显改善,电解质水平正常化.
结论:
- 这一案例强调了PPI和某些抗药物诱导持久电解质失衡的潜力.
- 对于老年人,多种药物治疗的患者来说,定期的药物审查至关重要,以防止不良药物事件和功能下降.
- 涉及药物戒断,饮食调整和优化抗高血压治疗的管理策略可以导致恢复.
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