何首乌致肝损害和中性粒细胞缺乏  

Hepatic damage and agranulocytosis due to Polygonum multiflorum

作　　者：刘贺萍[1] 吴新荣[1] 袁进[1] 

机构地区：[1]广州军区广州总医院药剂科,510010

出　　处：《药物不良反应杂志》2013年第5期298-300,共3页Adverse Drug Reactions Journal

摘　　要：1例20岁女性为乌发自行服用何首乌粉15g/d。2周后,患者出现纳差及乏力;3周后出现尿色加深,肝功能检查示天冬氨酸转氨酶（AST）878 U/L,丙氨酸转氨酶（ALT）1121 U/L,总胆红素（TBil）100.8μmol/L,直接胆红素（DBil T）77.4μmol/L。服用何首乌粉第42天,实验室检查：AST472 U/L,ALT 755 U/L,TBil 102.9μmol/L,DBil 76.7μmol/L;白细胞计数3.2×10~9/L,中性粒细胞计数0.27×10~9/L。考虑药物引起肝损害和中性粒细胞缺乏可能性大。停用何首乌,给予保肝、退黄等综合治疗。治疗10 d后实验室检查：ALT 62 U/L,AST 73 U/L,DBil 20.5μmol/L,TBil 30.2μmol/L;白细胞计数6.2×10~9/L,中性粒细胞计数3.60×10~9/L。A 20-year-old woman took herbal medicine Polygonum multiflorum powder 15 g/d by herself for blacking hair.Two weeks later,the patient presented with poor appetite and fatigue and,three weeks later,she experienced yellowish urine and liver function tests showed the following values：aspartate transaminase（AST） 878 U/L,alanine aminotransferase（ALT） 1121 U/L,total bilirubin（TBil） 100.8 μmol/L,direct bilirubin（DBil） 77.4μmol/L.On day 42 of using Polygonum multiflorum powder, laboratory test revealed the following levels;AST 472 U/L,ALT 755 U/L,TBil 102.9 μmol/L,DBil 76.7 μmol/L,WBC count 3.2×10~9/L,neutrophil count 0.27×10~9/L.Liver damage and agranulocytosis were considered to be probably produced by the medicine.Polygonum multiflorum was withdrawn and liverprotective medications were used to treat jaundice,and other comprehensive therapy were given.Ten days after treatment,laboratory test revealed the following levels：ALT 62 U/L,AST 73 U/L,DBil 20.5μmol/L,TBil 30.2 μmol/L,WBC count 6.2×10~9/L,neutrophil count 3.60×10~9/L.

关 键 词：何首乌 肝功能不全 中性粒细胞减少 

分 类 号：R595.3[医药卫生—内科学]