一位77岁老年女性患者，因“纯红细胞再生障碍性贫血”入院，住院期间先后给予左氧氟沙星0.2 g，ivgtt，bid，环孢素100 mg，po，q 12 h。两药联用1 d后，患者出现突发短暂抽搐、呼之不应、小便失禁等症状，10 min后稍缓解，30 min后出现四肢强直抽搐、意识丧志，双眼向左上凝视，口吐白沫，呼之不应等症状。给予安定10 mg静推，后下肢仍有间断震颤，停用环孢素，给予注射用丙戊酸钠0.4 g，ivgtt，bid对症治疗，症状稳定后改为丙戊酸缓释片0.5 g，bid维持治疗，患者之后仍处于不清醒状态。经分析认为该不良反应由药物相互作用导致环孢素血药浓度升高所致可能性较大，而由左氧氟沙星引起该反应的可能性较小。% One 77-year-old female patient, who was diagnosed with pure red cell aplastic anemia, was given levofloxacin (0.2 g, ivgtt, bid) and cyclosporine A (100 mg, po, q 12 h) successively. One day later, the patient developed transient tic, non-response to calling, urinary incontinence. Ten minutes later, the symptom slightly relieved. But 30 minutes later, the patient had symptoms with rigidity of limbs tic, unconsciousness, staring eyes on the left, foaming at the mouth and non-response to calling. Then she received diazepam (10 mg, iv), while she still had intermittent tremor in lower limbs. Then the cyclosporine was stopped and valproate sodium for injection (0.4 g, ivgtt, bid) was given for symptomatic treatment, after the condition was stable, valproate sodium for injection was replaced to sodium valproate sustained-release tablets (0.5 g, bid). The patient was still unconsciousness. The adverse drug reaction (ADR) may be caused by evaluated concentration of cyclosporin A when combination use of levofloxacin, while the possibility of levofloxacin-induced ADR was little.
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