替加环素致重度肝损伤1例  

One case of severe liver injury induced by tigecycline

作　　者：程刚英[1] 程彪 周庆[1] 刘珏[1] 王奕[1] 邓艾平[1] CHENG Gang-ying;CHENG Biao;ZHOU Qing;LIU Jue;WANG Yi;DENG Ai-ping(The Central Hospital of Wuhan,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430014,China)

机构地区：[1]华中科技大学同济医学院附属武汉中心医院,湖北武汉430014

出　　处：《中国药物应用与监测》2018年第6期378-380,共3页Chinese Journal of Drug Application and Monitoring

基　　金：国家自然科学基金青年科学基金项目(81603013)

摘　　要：1例61岁女性患者,因腹痛3 d入院,临床诊断为急性胃穿孔、感染性休克,在急诊全麻气管插管下行剖腹探查+胃穿孔修补术,术后给予抗休克、补液、抗感染治疗,治疗期间患者总胆红素进行性上升,最高升至158.9μmol·L^(-1),腹部CT提示胆汁淤积。医生排除疾病相关因素,临床药师考虑替加环素引起药物性肝损害可能性较大,建议停用替加环素。停药后患者总胆红素逐渐下降,停药后第43日患者肝功能指标完全恢复正常,腹部CT提示胆汁淤积消失,患者好转出院。A 61-year-old female patient was admitted to the hospital mainly because of abdominal pain for 3 days.She was diagnosed as acute gastric perforation and septic shock.Systematic treatment including anti-shock,rehydration and antiinfection were given to her after exploratory laparotomy and gastric perforation neoplasty.During the treatment,the total bilirubin increased as high as 158.9μmol·L^-1.The abdominal CT scan showed cholestasis.Disease-related factors of cholestasis was excluded by physicians.And tigecycline-induced liver injury was considered by clinical pharmacists.So tigecycline was stopped according to the advice of clinical pharmacist.The total bilirubin gradually decreased and dropped to the normal range on the 43rd day after tigecycline withdrawl.The abdominal CT scan showed no cholestasis,and she was discharged from the hospital.

关 键 词：药物性肝损伤 替加环素 卡泊芬净 药品不良反应 

分 类 号：R969.3[医药卫生—药理学]