舍曲林与阿托伐他汀钙合用致严重肝功能异常  

Severe abnormal hepatic function due to sertraline combined with atorvastatin calcium

作　　者：贺建华[1] 易进[1] 

机构地区：[1]首都医科大学附属北京安贞医院精神心理科,100029

出　　处：《药物不良反应杂志》2015年第6期467-468,共2页Adverse Drug Reactions Journal

摘　　要：1例冠状动脉支架置入术后口服阿托伐他汀钙（20mg／d）已7年的66岁女性患者，因出现抑郁症状给予舍曲林口服，初始剂量25mg／d，渐增加至150mg／d，抑郁症状明显好转。服用舍曲林第52天患者感极度乏力。实验室检查：丙氨酸转氨酶（ALT）1170U／L，天冬氨酸转氨酶（AST）805U／L，γ-谷氨酰转移酶（γ—GT）97U／L，总胆红素9．6μmol／L，直接胆红素3．1μmol／L。诊断为药物性肝损伤。停用舍曲林和阿伐他汀钙并给予保肝治疗后患者症状好转。停药后约半个月复查：ALT98U／L，AST47U／L，γ-GT101U／L；3个月复查：ALT12U／L，AST17U／L，γ-GT12U／L。A 66-year-old female patient, who was treated with atorvastatin calcium 20 mg once daily 7 years after coronary stent implantation, received sertraline for her depression. The initial dose of sertraline was 25 rng once daily and increased gradually to 150 mg once daily. Her depressive symptoms were improved obviously. Fifty-two days after beginning of sertraline treatment, the patient felt very weak and fatigued. Laboratory examination showed the following results： alanine aminotransferase （ALT） 1 170 U/L, aspartate aminotransferase （AST） 805 U/L, gamma-glutamyl transpeptidase （γ-GT） 97 U/L, total bilirubin 9.6μmol/L, direct bilirubin 3.1 μmol/L. Drug-induced liver injury was diagnosed. Sertraline and atorva-statin calcium were stopped and liver-protective treatments were given. Her liver function was improved. Two weeks after drug withdrawal, laboratory test showed ALT 98 U/L, AST 47 U/L,γ--GT 101 U/L and ALT 12 U/L, AST 17 U/L,γ-GT 12 U/L 3 months later.

关 键 词：药物性肝损伤 舍曲林 阿托伐他汀钙 

分 类 号：R575[医药卫生—消化系统]