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患者,徐××,男,20岁,于1994年4月26日下午,因上呼吸道感染,口服乙酰螺旋霉素2次,每次2片(每片剂量0.1克,杭州华东制药厂,批号930306).第二天起床后,即感头晕,恶心,视物旋转,即卧床休息,未再服药,自觉症状逐渐减轻,次日症状消失.因咽喉部疼痛,于上午9点左右又服乙酰螺旋霉素2片,至中午11时左右,上述症状又发,即卧床,不敢睁眼,于下午2时前来就诊.当时测血压14/lOKPa,心肺正常.眼球无震颤,予以用维生素B6,安定等治疗,并停用螺旋霉素,症状于28日上午消失,随访2d,未有类似症状发作.乙酰螺旋霉素是螺旋霉素的乙酰化衍生物,为半合成的大环内酯类抗生素,主要用于革兰氏阳性细菌和部分阴性细菌的感染,如肺炎双球菌,金葡菌,链球菌,卡他球菌等引起的上呼吸道感染及扁桃体炎,中耳炎等.本品毒性小,不良反应少,偶有食欲不振等胄肠道反应,个别病人有轻度头晕,但致眩晕发作未见报道.该患者2次服用乙酰螺旋霉素(以前未服用过)均致眩晕发作、停药后症状消失,故认为患者为乙酰螺旋霉素引起上述反应.
Patients, Xu × ×, male, 20 years old, on the afternoon of April 26, 1994, due to upper respiratory tract infection, oral acetylspiramycin 2 times, each 2 tablets (each dose of 0.1 grams, Hangzhou Huadong Pharmaceutical Factory, batch number The next day after getting up, that feeling dizzy, nausea, depending on the material rotation, that is, bed rest, no longer taking medicine, symptoms gradually reduced, the next day symptoms disappear due to throat pain, at about 9 am and convinced of acetyl Spiramycin 2, to about 11 noon, the above symptoms again, that bed rest, dare not open eyes, came to the clinic at 2 pm when the blood pressure was measured 14 / lOKPa, normal heart and lung eye without tremor, to be used vitamins B6, diazepam and other treatment, and disable spiramycin, the symptoms disappeared in the morning of the 28th, followed up 2d, no similar symptoms attack.Apiramycin is spiramycin acetylated derivatives, semi-synthetic macrocyclic Ester antibiotics, mainly for Gram-positive bacteria and some negative bacterial infections, such as pneumococcus, Staphylococcus aureus, Streptococcus, catarrhal caused by upper respiratory tract infection and tonsillitis, otitis media, etc. The toxicity of this product Small adverse reactions, occasional loss of appetite and other intestinal tract reactions, individual patients with mild dizziness, but to dizziness Seizures have not been reported .Two patients taking acetylspiramycin (previously not taken before) have caused dizziness attack, withdrawal symptoms disappear, so that patients with acetylspiramycin cause the above reaction.