摘要1例78岁患2型糖尿病30年、高血压病10余年、糖尿病肾病4年、肾性贫血数年的女性患者加用罗沙司他（70 mg口服、3次/周）治疗贫血。5 d后突发胸闷气喘、急性左心衰竭和双下肢凹陷性水肿；心电图示窦性停搏，逸搏心律，心率40次/min。实验室检查：血气分析示pH 7.31、血钾5.3 mmol/L，血肌酐304 μmol/L，B型利钠肽1 280.0 ng/L，高敏肌钙蛋白T 0.042 μg/L，肌酸激酶MB 0.83 μg/L。考虑为罗沙司他所致急性左心衰竭、高钾血症、代谢性酸中毒，停用罗沙司他和其他降糖、降压等长期口服药物，予碳酸氢钠、胰岛素、呋塞米、葡萄糖酸钙、血液滤过等治疗。2 d后患者心率和血钾恢复正常；7 d后患者B型利钠肽168.0 ng/L、血肌酐170 μmol/L、血钾4.13 mmol/L，无胸闷气喘，双下肢无水肿。恢复降糖、降压等长期口服药物，1个月后随访，患者未再出现胸闷气喘症状，复查电解质正常。

abstractsA 78-year-old female patient with type 2 diabetes for 30 years, hypertension for more than 10 years, diabetes nephropathy for 4 years, and renal anemia for several years additionally received roxadustat (70 mg thrice per week orally) for anemia. After 5 days, the patient developed sudden chest tightness, asthma, acute left heart failure, and depressed edema of both lower limbs. The electrocardiogram showed sinus arrest, escape rhythm, and a heart rate of 40 beats per minute. Laboratory test results showed blood pH 7.31, blood potassium 5.3 mmol/L, blood creatinine 304 μmol/L, B-type natriuretic peptide 1 280.0 ng/L, high-sensitivity troponin T 0.042 μg/L, and creatine kinase MB 0.83 μg/L. Acute left heart failure, hyperkalemia, and metabolic acidosis caused by roxadustat were considered. Roxadustat and other long-term oral medication such as hypoglycemic and antihypertensive drugs were discontinued. Symptomatic treatments such as sodium bicarbonate, insulin, furosemide, calcium gluconate, and blood filtration were given. Two days later,the patient′s heart rate and blood potassium returned to normal; 7 days later, the patient′s B-type natriuretic peptide was 168.0 ng/L, blood creatinine was 170 μmol/L, and blood potassium was 4.13 mmol/L. The patient had no chest tightness or asthma, and no edema in both lower limbs. Long-term oral medication such as hypoglycemic and antihypertensive drugs were given again. At a 1 month follow-up, the patient did not experience chest tightness or asthma, and the electrolyte levels were normal.