活力苏口服液致重度肝损伤2例
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摘要
病例1:1例29岁男性患者,因"斑脱"口服活力苏口服液(10 mL,qn)60 d,后因"眼黄、尿黄1周"入院,临床诊断为肝功能不全。肝功能:AST 1412 U·L~(-1),ALT 2801 U·L~(-1),ALP 122 IU·L~(-1),TBil 193.8μmol·L~(~(-1)),DBil 149.3μmol·L~(-1),患者既往无基础疾病,2个月前体检肝功能正常,否认药物、食物过敏史。病例2:1例29岁男性患者,因前列腺疾病多年,口服活力苏口服液(10 mL,qn)50 d,后因"尿黄、眼黄伴上腹痛1周"入院,拟"肝功能不全"收住入院,入院后查肝功能:AST 951U·L~(-1),ALT 2237 U·L~(-1),ALP 156 IU·L~(-1),TBil 166.9μmol·L~(-1),DBil 131.5μmol·L~(-1)。患者否认肝炎病史,否认药物、食物过敏史。2例患者用药史单一,肝功能损伤考虑为活力苏口服液相关不良反应,立即停用活力苏口服液,给予护肝、降酶、退黄治疗,27～37 d后患者肝功能恢复至正常。
Case 1: One 29-year-old male patient was treated with Huolisu oral liquid(10 mL, qn) due to alopecia areata for about 60 days. And then he was hospitalized due to yellow eyes and dark urine for one week and was diagnosed as hepatic insufficiency.Lab results of liver function were as follows: AST 1412 U·L~(-1), ALT 2801 U·L~(-1), ALP 122 IU·L~(-1), TBil 193.8 μmol·L~(-1), DBil 149.3μmol·L~(-1). The patient had been healthy before and had no history of drug and food allergies. And his lab results of liver function were normal two months ago. Case 2: One 29-year-old male patient was treated with Huolisu oral liquid(10 mL, qn) due to prostatic disease for about 50 days. And then he was hospitalized due to yellow eyes, dark urine and epigastric pain for 1 week and was diagnosed as hepatic insufficiency. Lab results of liver function were as follows: AST 951 U·L~(-1), ALT 2237 U·L~(-1), ALP 156 IU·L~(-1), TBil 166.9μmol·L~(-1), DBil 131.5 μmol·L~(-1). The patient denied history of hepatitis and had no history of drug and food allergies. Based on the relatively simple medication history of the two patients and literature review, Huolisu oral liquid induced liver injury was considered,Huolisu oral liquid was stopped immediately and symptomatic treatment including protecting liver function, lowering liver transaminase,lowering stained yellow were given to them. Their liver function returned to normal range about 27 – 37 days later.
Case 1: One 29-year-old male patient was treated with Huolisu oral liquid(10 mL, qn) due to alopecia areata for about 60 days. And then he was hospitalized due to yellow eyes and dark urine for one week and was diagnosed as hepatic insufficiency.Lab results of liver function were as follows: AST 1412 U·L~(-1), ALT 2801 U·L~(-1), ALP 122 IU·L~(-1), TBil 193.8 μmol·L~(-1), DBil 149.3μmol·L~(-1). The patient had been healthy before and had no history of drug and food allergies. And his lab results of liver function were normal two months ago. Case 2: One 29-year-old male patient was treated with Huolisu oral liquid(10 mL, qn) due to prostatic disease for about 50 days. And then he was hospitalized due to yellow eyes, dark urine and epigastric pain for 1 week and was diagnosed as hepatic insufficiency. Lab results of liver function were as follows: AST 951 U·L~(-1), ALT 2237 U·L~(-1), ALP 156 IU·L~(-1), TBil 166.9μmol·L~(-1), DBil 131.5 μmol·L~(-1). The patient denied history of hepatitis and had no history of drug and food allergies. Based on the relatively simple medication history of the two patients and literature review, Huolisu oral liquid induced liver injury was considered,Huolisu oral liquid was stopped immediately and symptomatic treatment including protecting liver function, lowering liver transaminase,lowering stained yellow were given to them. Their liver function returned to normal range about 27 – 37 days later.
引文
[1]中华医学会肝病学会药物性肝病学组.药物性肝损伤诊治指南[J].中华肝脏病杂志,2015,23(11):810-820.
[2]中华中医药学会肝胆病分会,中华中医药学会中成药分会.中草药相关肝损伤临床诊疗指南[J].临床肝胆病杂志,2016,32(5):835-843.
[3]王海珍,李秀惠.33例何首乌及其相关制剂致药物性肝损伤临床分析[J].中西医结合肝病杂志,2018,28(1):25-27.
[4]常越,刘沁雨,吕成娇,等.39例何首乌致急性药物性肝损伤的临床特点[J].肝脏,2018,23(8):670-672.
[5]雷飞,杨定权,甘超男,等.何首乌制剂致急性肝损伤1例[J].世界中西医结合杂志,2015,10(1):114-115,117.
[6]赵建学,陆玮婷,刘熳天,等.活力苏口服液与优甲乐同服致严重肝损伤2例报告[J].临床肝胆病杂志,2015,31(7):1128-1129.
[7]涂灿,蒋冰倩,赵艳玲,等.何首乌炮制前后对大鼠肝脏的损伤比较及敏感指标筛选[J].中国中药杂志,2015,40(4):654-660.
[8]林艳,肖榕,李春,等.生/制/发酵何首乌化学成分、药理作用及肝毒性研究进展[J].中药新药与临床药理,2018,29(5):661-672.
[9]邵幼林,张锁才,吴剑明,等.何首乌再激发药物性肝损伤的临床特征[J].中华肝脏病杂志,2018,26(9):686-689.
[2]中华中医药学会肝胆病分会,中华中医药学会中成药分会.中草药相关肝损伤临床诊疗指南[J].临床肝胆病杂志,2016,32(5):835-843.
[3]王海珍,李秀惠.33例何首乌及其相关制剂致药物性肝损伤临床分析[J].中西医结合肝病杂志,2018,28(1):25-27.
[4]常越,刘沁雨,吕成娇,等.39例何首乌致急性药物性肝损伤的临床特点[J].肝脏,2018,23(8):670-672.
[5]雷飞,杨定权,甘超男,等.何首乌制剂致急性肝损伤1例[J].世界中西医结合杂志,2015,10(1):114-115,117.
[6]赵建学,陆玮婷,刘熳天,等.活力苏口服液与优甲乐同服致严重肝损伤2例报告[J].临床肝胆病杂志,2015,31(7):1128-1129.
[7]涂灿,蒋冰倩,赵艳玲,等.何首乌炮制前后对大鼠肝脏的损伤比较及敏感指标筛选[J].中国中药杂志,2015,40(4):654-660.
[8]林艳,肖榕,李春,等.生/制/发酵何首乌化学成分、药理作用及肝毒性研究进展[J].中药新药与临床药理,2018,29(5):661-672.
[9]邵幼林,张锁才,吴剑明,等.何首乌再激发药物性肝损伤的临床特征[J].中华肝脏病杂志,2018,26(9):686-689.