在治疗类风湿性关节炎方面金盐起着重要的作用。尽管它们具有高的危险性,但危及生命的反应却很少发生。非肠道用金的制剂有硫代苹果酸金钠,硫代葡萄糖金。前者制成水溶液应用后偶可致高血压症状,后者混悬于芝麻油中则不发生这类反应。这些所谓的亚硝酸盐样的反应被描绘得非常可怕但非常短暂,可能由于水溶液吸收过快引起。曾有报道在注射硫代苹果酸金钠后可出现严重的急性反应包括心梗和心绞痛等,本文报道了在亚硝酸盐样作用后的脑部缺血及死亡情况。 1名71岁妇女在使用非甾类抗炎药和柳氮磺胺吡啶无效后,开始应用金盐治疗类风湿性关节炎。治疗初期方案中包括泼尼松,每日口服1次10mg;肌注硫代苹果酸金钠25mg,每日1次,2周后增加至50mg/周。其它医疗问题如:高血压用AcE抑制剂治疗。病人曾发生过脑血管意外,留有面肌麻痹和单侧肌无力后遗症。病人对金制剂的反应很满意,治疗持续31周。在常规金注射后,无其它明显临床变化,有恶心、呕吐、出汗和死亡逼近的感觉,此时血 Gold salts play an important role in the treatment of rheumatoid arthritis. Despite their high risk, life-threatening reactions rarely occur. Preparation of parenteral gold sodium thiomalate, glucosamine gold. The former made even after the application of aqueous solution can cause hypertension symptoms, the latter is not suspended in sesame oil such reactions occur. These so-called nitrite-like reactions are depicted as very horrible but very short-lived, possibly due to excessive absorption by the aqueous solution. It has been reported that severe acute reactions such as myocardial infarction and angina occur after injection of gold sodium thiomalate. This article reports on brain ischemia and death following nitrite-like effects. A 71-year-old woman started the treatment of rheumatoid arthritis with gold salts after the use of non-steroidal anti-inflammatory drugs and sulfasalazine was ineffective. Prednisone was administered in the initial treatment regimen, 10 mg once daily orally; intramuscular injection of 25 mg sodium gold thiomalate once daily and 50 mg / week after 2 weeks. Other medical problems such as: hypertension with AcE inhibitors. Patients have had cerebrovascular accidents, leaving facial paralysis and unilateral muscle weakness sequelae. Patient response to gold preparations is very satisfactory, the treatment lasted for 31 weeks. After the conventional gold injection, no other obvious clinical changes, nausea, vomiting, sweating and death approaching feeling, when the blood