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与用于抑制呼吸机驱动的雷米芬坦尼尔可能相关的中性症:一个病例报告
Hayato Watanabe1, Kimito Minami1, Muneyuki Takeuchi1
1Department of Critical Care Medicine National Cerebral and Cardiovascular Center Osaka Japan.
Clinical case reports
|February 12, 2026
概括
本案例研究发现了一种罕见的不良反应:雷米芬坦尼尔诱导的中性质衰竭. 患者的中性粒细胞数在停止使用雷米芬坦尼尔后恢复,这表明有直接联系.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 血液学 血液学 血液学
背景情况:
- 中性是各种药物的潜在副作用.
- 雷米芬坦尼尔是一种超短作用的阿片类药物,通常用于重症监护机构.
- 与雷米芬坦尼尔相关的血液毒性以前没有被记录.
研究的目的:
- 报告一种罕见的严重中性质衰竭病例,可能是由雷米芬坦尼尔引起的.
- 强调考虑药物诱导的血液毒性的重要性.
- 强调及时识别和管理药物不良反应.
主要方法:
- 一个81岁的男性患者在主动脉手术后的病例报告.
- 在用于呼吸辅助的雷米芬坦尼尔输液期间监测中性粒细胞计数.
- 药物戒断 (解除挑战) 和重新引入 (重新挑战) 来评估因果关系.
- 使用颗粒细胞殖民地刺激因子.
主要成果:
- 患者在接受雷米芬坦尼尔治疗时出现严重的中性质衰竭 (中性质粒细胞数量为2400/μL).
- 在Remifentanil停药后,中性粒细胞数量恢复正常.
- 在重新引入雷米芬坦尼尔后,中性再次复发,证实了时间关系.
- 在停止使用雷米芬坦尼尔之前,花细胞殖民地刺激因子并没有消除中性热症.
结论:
- 雷米芬坦尼尔被强烈认为是该患者中性衰竭的原因.
- 这一案例代表了一种新的药物不良反应.
- 临床医生应保持对所有药物,包括雷米芬坦尼尔,血液毒性的警.
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