NEJM:绿色尿液-病例报道

2020-12-03 MedSci原创 MedSci原创

尿液的绿色变色可能归因于许多因素,包括药物治疗(例如丙泊酚、消炎痛、阿米替林、西咪替丁和亚甲基蓝),阻塞性黄疸和感染假单胞菌。

患者为一名62岁的男子,伴有慢性阻塞性肺疾病,因呼吸困难2天而被送往急诊就诊,发现伴有高碳酸血症性呼吸衰竭。当即进行了气管插管,开始了机械通气并连续输注了异丙酚,并将患者送入重症监护病房(ICU)。

进入重症监护病房五天后,该患者的尿液变成绿色。尿液的绿色变色可能归因于许多因素,包括药物治疗(例如丙泊酚、消炎痛、阿米替林、西咪替丁和亚甲基蓝),阻塞性黄疸和感染假单胞菌。

该患者的血清总胆红素水平正常,未显示感染迹象,除丙泊酚外未服用其他任何可解释尿液变色的药物。停止输注异丙酚后,尿液颜色恢复正常。住院2周后,患者被送往康机构。

丙泊酚主要在肝脏中代谢,推测当其通过肾脏排出时,其酚类代谢物会引起尿液绿色变色。代谢物无肾毒性,丙泊酚引起的尿液变绿是良性且罕见的现象。

原始出处:

Maja Boshkovska Spaseski,et al.Green Urine.N Engl J Med.2020;https://www.nejm.org/doi/full/10.1056/NEJMicm2017137

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  1. [GetPortalCommentsPageByObjectIdResponse(id=905118, encodeId=881f90511803, content=我以为铁离子<a href='/topic/show?id=c9d44e392a5' target=_blank style='color:#2F92EE;'>#尿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47392, encryptionId=c9d44e392a5, topicName=尿)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Sat Dec 05 09:57:06 CST 2020, time=2020-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449396, encodeId=2d99144939650, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Fri Dec 04 23:21:35 CST 2020, time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904589, encodeId=842890458932, content=***,活久见<a href='/topic/show?id=8d538e69163' target=_blank style='color:#2F92EE;'>#药物副作用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87691, encryptionId=8d538e69163, topicName=药物副作用)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210607/9f00a0de660e4b36b77a9a5f7620d6bf/98c22b17ddf7446fa7b9a618fabcb9f7.jpg, createdBy=a8fb2299762, createdName=Psycho.Dr Du, createdTime=Thu Dec 03 13:59:45 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035513, encodeId=71421035513a1, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Dec 03 11:21:35 CST 2020, time=2020-12-03, status=1, ipAttribution=)]
    2020-12-05 神盾医疗局局长Jack

    我以为铁离子#尿#

    0

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    2020-12-03 Psycho.Dr Du

    ***,活久见#药物副作用#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=905118, encodeId=881f90511803, content=我以为铁离子<a href='/topic/show?id=c9d44e392a5' target=_blank style='color:#2F92EE;'>#尿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=110, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47392, encryptionId=c9d44e392a5, topicName=尿)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200529/3611e9bb629c4e5b81fbd8ce784b06cc/128487eae357460bb98f67d86230c218.jpg, createdBy=ab235268530, createdName=神盾医疗局局长Jack, createdTime=Sat Dec 05 09:57:06 CST 2020, time=2020-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1449396, encodeId=2d99144939650, content=<a href='/topic/show?id=b3e24e442bc' target=_blank style='color:#2F92EE;'>#尿液#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47442, encryptionId=b3e24e442bc, topicName=尿液)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4dfa37, createdName=智者为医08, createdTime=Fri Dec 04 23:21:35 CST 2020, time=2020-12-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=904589, encodeId=842890458932, content=***,活久见<a href='/topic/show?id=8d538e69163' target=_blank style='color:#2F92EE;'>#药物副作用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=87691, encryptionId=8d538e69163, topicName=药物副作用)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210607/9f00a0de660e4b36b77a9a5f7620d6bf/98c22b17ddf7446fa7b9a618fabcb9f7.jpg, createdBy=a8fb2299762, createdName=Psycho.Dr Du, createdTime=Thu Dec 03 13:59:45 CST 2020, time=2020-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1035513, encodeId=71421035513a1, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Thu Dec 03 11:21:35 CST 2020, time=2020-12-03, status=1, ipAttribution=)]
    2020-12-03 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

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