摘要
1例38岁女性甲状腺结节患者接受行气散结膏30 g口服、2次/d治疗,1个月为1个疗程,共用药4个疗程,2个疗程之间间隔14 d。末次疗程第29天,患者出现纳差,皮肤、巩膜黄染和尿液颜色加深,实验室检查示丙氨酸转氨酶(ALT)3201 U/L,天冬氨酸转氨酶(AST)2262 U/L,总胆红素(TBil)257.2μmol/L,直接胆红素(DBil)186.9μmol/L,碱性磷酸酶(ALP)159 U/L。诊断为药物性肝损伤(重度),考虑与行气散结膏有关。停用该药,予保肝、补液等对症支持治疗。22 d后患者上述症状改善,实验室检查示ALT 209 U/L,AST 117 U/L,TBil 92.7μmol/L,DBil 63.2μmol/L,ALP 82 U/L。51 d后患者皮肤、巩膜黄染消退,尿液颜色恢复正常,实验室检查示ALT 37 U/L,AST 22 U/L,、TBil 30.3μmol/L,DBil 14.7μmol/L,ALP 58 U/L。
A 38-year-old female patient with thyroid nodule received Xingqi Sanjie cream 30 g orally twice daily for 4 treatment courses in total.Each treatment course was 1 month and the interval between the 2 courses was 14 days.On the 29th day of the 4th treatment course,the patient developed poor appetite,yellowish skin and sclera,and dark urine.Laboratory tests showed alanine aminotransferase(ALT)3-201-U/L,aspartate aminotransferase(AST)2-262-U/L,total bilirubin(TBil)257.2-μmol/L,direct bilirubin(DBil)186.9-μmol/L,and alkaline phosphatase(ALP)159-U/L.Drug-induced liver injury(severe)was diagnosed,which was considered to be related to Xingqi Sanjie cream.The drug was stopped,and symptomatic and supportive treatments including hepatoprotection and rehydration were given.Twenty-two days later,the above symptoms in the patient were improved.Laboratory tests showed ALT 209-U/L,AST 117-U/L,TBil 92.7-μmol/L,DBil 63.2-μmol/L,and ALP 82-U/L.Fifty-one days later,the yellowish skin and sclera in the patient subsided,and the urine color returned to normal.Laboratory tests showed ALT 37-U/L,AST 22-U/L,TBil 30.3-μmol/L,DBil 14.7μmol/L,and ALP 58-U/L.
作者
刘金春
严晓敏
Liu Jinchun;Yan Xiaomin(Department of Pharmacy,Nanjing Drum Tower Hospital,Nanjing Medical Center for Clinical Pharmacy,Nanjing 210008,China;Department of Infectious Diseases,Nanjing Drum Tower Hospital,Nanjing 210008,China)
出处
《药物不良反应杂志》
CSCD
2022年第12期667-669,共3页
Adverse Drug Reactions Journal
基金
中国毒理学会临床毒理专项研究课题(CST2019CT305)
南京大学医院管理研究所课题项目和南京鼓楼医院医学发展医疗救助基金会资助项目(NDYG2020052)。
关键词
中草药
药物性肝损伤
行气散结膏
Drugs
Chinese herbal
Drug induced liver injury
Xingqi Sanjie cream
