毒理性
静脉注射头孢曲松与3%至46%的患者发生胆泥形成有关。儿童的发生率可能高于成人，并且与较高剂量、较长疗程以及可能的禁食或脱水有关。该综合征被称为“假性结石症”，因为泥沙和结石主要是由头孢曲松组成，停止用药后它们会自发解决，这表明可以避免手术。大多数病例发生时症状轻微或无症状。据报道，多达5%的患者出现胆囊炎的明显症状。即使有胆绞痛，血清酶和胆红素水平通常保持正常，但在罕见情况下，可能会出现胆汁淤积性黄疸或胆石性胰腺炎，这可能会很严重，需要手术治疗。胆泥和胆囊疾病的症状可能在开始治疗后的几天内出现，但通常在停止头孢曲松后迅速解决，尽管泥沙和胆结石可能通过超声检测数月。
Parenteral administration of ceftriaxone has been associated with development of biliary sludge in 3% to 46% of patients. The incidence may be higher in children than adults and is associated with higher doses and longer courses of treatment and possibly with fasting or dehydration. The syndrome is referred to as “pseudo-lithiasis” as the sludge and stones consist largely of ceftriaxone and they resolve spontaneously when the drug is stopped, indicating that surgery can be avoided. Most cases occur with minimal or no symptoms. Frank symptoms of cholecystitis are reported in up to 5% of patients who develop pseudo-lithiasis. Typically, serum enzymes and bilirubin levels remain normal even with biliary colic, but in rare instances there is cholestatic jaundice or gallstone pancreatitis that can be severe and require surgical intervention. Sludge and symptoms of gallbladder disease can arise within a few days of starting therapy, but typically resolve rapidly once ceftriaxone is stopped, although sludge and gallstones may be detectable by ultrasound for several months.
来源:LiverTox
