仙灵骨葆胶囊与奥美拉唑联用致肝损害及乙型肝炎再活动  

Hepatic injury and hepatitis B virus reactivation due to concomitant use of Xianlinggubao (仙灵骨葆) capsules and omeprazole

作　　者：赵晓卫[1] 徐灿丽[1] 

机构地区：[1]首都医科大学附属北京地坛医院门诊,100015

出　　处：《药物不良反应杂志》2012年第1期60-61,共2页Adverse Drug Reactions Journal

摘　　要：1例57岁女性非活动性HBsAg携带者10年间多次随访肝功能均正常,乙型肝炎病毒(HBV)DNA<500拷贝/ml。因骨折服用0.5 g仙灵骨葆胶囊3粒,2次/d。2个月后患者出现胃部不适,加服奥美拉唑20 mg、1次/d;0.18 g灯盏生脉胶囊2粒,2次/d。联合用药3个月后,患者出现肝功能异常,丙氨酸转氨酶(ALT)389 U/L,天冬氨酸转氨酶(AST)229 U/L。诊断为药物性肝损害、乙型肝炎再活动。停药并接受甘草酸二铵胶囊、参芪肝康胶囊保肝治疗。1周后复查肝功能:ALT 236 U/L,AST 120 U/L,HBV DNA 1.25×106拷贝/ml;2周后实验室检查:ALT 73 U/L,AST 54 U/L,HBV DNA 2.36×105拷贝/ml。A 57-year-old woman with inactive HBsAg carrier had normal hepatic function and hepatitis B virus （HBV） DNA levels 〈 500 copies/ml during the past 10 years of follow-up. She received 3 capsules of Xianlinggubao （仙灵骨葆） 0.5 g twice daily due to fracture. Two months later, omeprazole 20 mg once daily and 2 capsules of Dengzhanshengmai （灯盏生脉） 0. 18 g twice daily were added to her treatment regimen for stomach discomfort. After three months of concomitant use of these medications, her liver function tests were abnormal as follows： alanine aminotransferase （ALT） 389 U/L and aspartate aminotransferase （AST） 229 U/L. She was diagnosed with drug-induced hepatitis and hepatitis B virus reactivation. The above-mentioned drugs were stopped and she was given diammonium glycyrrhizinate capsules and Shenqigankang （参芪肝素） capsules for liver protection treatment. A week later, repeat liver function tests showed the following levels： ALT 236 U/L, AST 120 U/L, HBV DNA 1.25 × 10^6 copies/ml. Two weeks later, the laboratory indices revealed the following levels： ALT 73 U/L,AST 54 U/L,HBV DNA 2.36 × 10^5 copies/ml.

关 键 词：奥美拉唑 乙型肝炎 肝功能不全 仙灵骨葆 

分 类 号：R512.62[医药卫生—内科学]