中国药物警戒 ›› 2023, Vol. 20 ›› Issue (2): 209-212.
DOI: 10.19803/j.1672-8629.20211205

• 安全与合理用药 • 上一篇    下一篇

阿司匹林片致冠心病患者出血性甲状腺肿大1例分析

丁倩1,2, 李博宇3Δ, 张青霞1*   

  1. 1首都医科大学宣武医院药学部,国家老年疾病临床医学研究中心,北京 100053;
    2国家儿童医学中心,首都医科大学附属北京儿童医院药学部,北京 100045;
    3首都医科大学宣武医院心脏内科,北京 100053
  • 收稿日期:2022-01-30 出版日期:2023-02-15 发布日期:2023-02-17
  • 通讯作者: *张青霞,女,硕士,副主任药师,心血管等慢病药物治疗管理及用药安全管理。E-mail: wl7322681@sina.com
  • 作者简介:丁倩,女,硕士,药师,临床药学。Δ为并列第一作者。
  • 基金资助:
    国家重点研发计划（2020YFC2008305）; 北京市科学技术委员会“老年人多重用药管理模式的建立与临床应用研究”专项资助课题（D181100000218002）

Analysis of one case of hemorrhagic goiter caused by aspirin tablets in one patient with coronary heart disease

DING Qian1,2, LI Boyu3Δ, ZHANG Qingxia1*   

  1. 1Department of Pharmacy, Xuanwu Hospital of Capital Medical University, National Geriatric Disease Clinical Research Center, Beijing 100053, China;
    2Department of Pharmacy, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China; School of Pharmacy, Capital Medical University, Beijing 100069, China;
    3Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
  • Received:2022-01-30 Online:2023-02-15 Published:2023-02-17

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摘要： 目的 关注阿司匹林对甲状腺的影响。方法 通过分析1例阿司匹林引起出血性甲状腺肿大的病例,从用药与不良反应的相关性、阿司匹林致出血性甲状腺肿大的药学分析和药学建议等方面进行讨论。结果 患者服用阿司匹林前甲状腺超声提示多发结节、甲状腺功能正常,服药24 d后患者发现颈部肿大且越来越明显,甲状腺超声提示有血流信号,4个月后就诊医药联合门诊,药师和医生建议停用阿司匹林并复查甲状腺功能正常,停药10 d后自觉颈部肿大逐渐缩小,1个多月后颈部肿大完全消退、复查甲状腺超声未见血流信号。结论 服用阿司匹林的患者甲状腺肿大可能是阿司匹林出血导致,应引起医生和药师的关注,建议服用阿司匹林的患者若出现甲状腺肿大应行甲状腺功能和甲状腺超声检查,尤其是既往有甲状腺疾病的患者。

关键词: 甲状腺, 冠心病, 阿司匹林, 出血, 药品不良反应, 药学分析

Abstract: Objective To study the effect of aspirin on the thyroid gland. Methods By analyzing one case of hemorrhagic goiter caused by aspirin, the correlations between medication and adverse drug reactions were investigated. Results Before the patient took aspirin, ultrasound of the patient’s thyroid gland showed multiple nodules and normal thyroid function. Twenty-four days after taking the medicine, the patient’s neck became increasingly swollen, and the thyroid ultrasound showed blood flow signals. After four months, she came back to see a doctor and a pharmacist, both of whom suggested discontinuing aspirin and rechecking thyroid function. Ten days after drug withdrawal, the swelling of the neck gradually shrank. More than one month later, the swelling completely subsided. No blood flow signal was found by thyroid ultrasound. Conclusion Goiter among patients taking aspirin may be caused by aspirin-related bleeding, which should attract the attention of doctors and pharmacists. It is suggested that patients taking aspirin should have their thyroid function examined and receive thyroid ultrasound examination in case of goiter, especially those with previous thyroid diseases.

Key words: thyroid, coronary heart disease, aspirin, bleeding, adverse drug reaction, pharmaceutical analysis

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