甲巯咪唑致胆汁淤积型肝损伤  

Thiamazole-lnduced cholestatic liver injury

作　　者：王璐[1,2] 纪立伟[1] 

机构地区：[1]国家卫生和计划生育委员会北京医院药学部,100730 [2]北京市西山医院药剂科

出　　处：《药物不良反应杂志》2013年第2期96-97,共2页Adverse Drug Reactions Journal

基　　金：卫生行业科研专项基金(200902008-03)

摘　　要：1例51岁女性患者因甲状腺功能亢进症服用甲巯咪唑5 mg,1次/d,10 d后出现皮肤瘙痒、恶心、呕吐、大便呈灰白色,第15天停用甲巯咪唑。实验室检查示丙氨酸转氨酶(ALT)184 U/L,天冬氨酸转氨酶(AST)115 U/L,总胆红素(TBil)41.6μmol/L,直接胆红素(DBil)28.6μmol/L,碱性磷酸酶(ALP)342 U/L。考虑为药物所致胆汁淤积型肝损伤。遂静脉滴注脱氧核苷酸钠注射液150 mg,1次/d和注射用复合辅酶400 U,2次/d。保肝治疗第7天ALT 150 U/L,AST 67 U/L,TBil28.7μmol/L,DBIL19.1μmol/L;第13天ALT93 U/L,AST57 U/L;第28天ALT62 U/L,AST45 U/L,TBil 11.1μmol/L,DBil 5.8μmol/L。A 51-year-old woman with hyperthyroidism was given thiamazole 5 mg once daily. Ten days later, the patient presented itchiness, nausea, vomiting, and gray excrements. On day 15, the thiamazole was withdrawn. Laboratory examination revealed the following levels： alanine aminotransferase （ALT） 184 U/L, aspartate aminotransferase （AST） 115 U/L, total biliruhin（TBil） 41.6 μmol/L, and direct bilirubin （DBil） 28.6 μmol/L. The patient was considered as cholestatic liver injury. She was given an IV infusion of sodium deoxyribonucleotide injection 150 mg once daily and coenzyme complex for injection 400 U twice daily. On day 7 of liver-protective treatment, laboratory examination showed the following levels： ALT 150 U/L,AST 67 U/L, TBil 28.7 μmol/L, and DBil 19.1 μmol/L. On day 13, the levels of ALT and AST were 93 U/L,and 57 U/L, respectively. On day 28, the levels of ALT, AST,TBil and DBil were 62 U/L, 45 U/L, 11.1 μmoL/L, and 5.8 μmol/L, respectively.

关 键 词：甲巯咪唑 胆汁淤积 肝内 

分 类 号：R595.3[医药卫生—内科学]