误服黄独零余子致急性中毒性肝损伤  

Acute toxic liver injury caused by mistaken use of air potato(Dioscorea bulbifera L.)

作　　者：史丁一 孙艺铭 Shi Dingyi;Sun Yiming(Clinical Pharmaceutics Office,Weihai Hospital of Traditional Chinese Medicine,Shandong Province,Weihai 264200,China)

机构地区：[1]山东省威海市中医院临床药学室,264200

出　　处：《药物不良反应杂志》2020年第8期488-489,共2页Adverse Drug Reactions Journal

摘　　要：1例59岁女性患者为保健误将黄独零余子当作何首乌每日1枚蒸熟服用,服用10 d(第10天服2枚)后出现黄疸、乏力、纳差、恶心等症状。实验室检查:丙氨酸转氨酶(ALT)1090 U/L,天冬氨酸转氨酶(AST)2620 U/L,γ-谷氨酰转移酶(γ-GT)98 U/L,总胆红素(TBil)566.3μmol/L,直接胆红素(DBil)301.5μmol/L,总胆汁酸(TBA)351.4μmol/L。诊断为黄独零余子中毒性肝炎,给予复方甘草酸苷注射液、注射用还原型谷胱甘肽和茵栀黄注射液静脉滴注,熊去氧胆酸片和中药汤剂口服。25 d后肝功能明显好转,ALT 39 U/L,AST 90 U/L,γ-GT 115 U/L,TBil 60.6μmol/L,DBil 34.5μmol/L,TBA 121.5μmol/L。A 59-year-old female patient mistakenly took air potato(Dioscorea bulbifera L.)as Polygonum multiflorum(1 steamed piece daily,and 2 on the last day)for healthcare.Ten days later,the patient developed jaundice,fatigue,anorexia,and nausea.Laboratory tests showed alanine aminotransferase(ALT)1090 U/L,aspartate aminotransferase(AST)2620 U/L,gamma-glutamyltransferase(γ-GT)98 U/L,total bilirubin(TBil)566.3μmol/L,direct bilirubin(DBil)301.5μmol/L,and total bile acid(TBA)351.4μmol/L.Toxic hepatitis caused by air potato was diagnosed.IV infusions of compound glycyrrhizin injection,reduced glutathione for injection,and Yinzhihuang injection(茵栀黄注射液)and oral ursodeoxycholic acid tablets and traditional Chinese medicine decoction were given.After 25 days of treatments,her liver function were improved obviously,and laboratory tests showed ALT 39 U/L,AST 90 U/L,γ-GT 115 U/L,TBil 60.6μmol/L,DBil 34.5μmol/L,and TBA 121.5μmol/L.

关 键 词：薯蓣属 植物中毒 化学和药物性肝损伤 黄独零余子 

分 类 号：R595.4[医药卫生—内科学]