吉非替尼片致严重血清转氨酶升高伴急性胆囊炎1例分析  

One Case of Severe Serum Transaminase Elevation with Acute Cholecystitis Induced by Gefitinib Tablets

作　　者：廖玉芳 岳建农 司可 LIAO Yufang;YUE Jiannong;SI Ke(Department of Pharmacy,Chongqing Qianjiang Central Hospital,Qianjiang Chongqing 409099,China;Medical Insurance Office,Chongqing Qianjiang Central Hospital,Qianjiang Chongqing 409099,China;Intensive Care Unit,Chongqing Qianjiang Central Hospital,Qianjiang Chongqing 409099,China)

机构地区：[1]重庆市黔江中心医院药学部,重庆黔江409099 [2]重庆市黔江中心医院医保办,重庆黔江409099 [3]重庆市黔江中心医院重症医学科,重庆黔江409099

出　　处：《中国药物警戒》2021年第6期584-587,共4页Chinese Journal of Pharmacovigilance

基　　金：重庆市卫生计生委-医学科研项目基金(2015MSXM135);重庆市黔江区科技局科研项目基金(2019054)。

摘　　要：目的探讨吉非替尼引起严重血清转氨酶升高伴急性胆囊炎的机制和诊疗措施。方法临床药师对1例长期口服吉非替尼后出现严重血清转氨酶升高伴急性胆囊炎进行分析,复习相关文献,探讨吉非替尼诱发肝损伤合并胆囊炎的发病机制及处置措施,为临床医生用药提供参考。结果吉非替尼引起血清转氨酶严重升高伴急性胆囊炎是一种罕见的严重不良反应,通过停用吉非替尼并给予积极保肝治疗后,患者肝胆情况得到明显恢复。结论本病例是吉非替尼罕见不良反应,并在临床应用中提出新的药学监护要点,对保证患者用药安全具有积极作用。Objective To investigate the mechanism and treatments of severe serum transaminase elevation complicated with acute cholecystitis induced by gefitinib.Methods T he clinical p harmacist a nalyzed o ne case of severe serum transaminase elevation complicated with acute cholecystitis after receiving longterm oral gefitinib.The related literature was reviewed,while the pathogenesis and treatments of gefitinibinduced liver injury with cholecystitis were explored.Results G efitinib-caused s evere elevation of s erum transaminase with acute cholecystitis was a rare serious adverse reaction.After gefitinib was discontinued and active hepatoprotective treatment was adopted,the patient’s liver and gallbladder condition was significantly improved.Conclusion This case is a rare adverse reaction of gefitinib,and new priorities of pharmaceutical care have been proposed in clinical application,which can contribute to ensuring the safety of patients'medication.

关 键 词：吉非替尼 转氨酶 急性胆囊炎 药品不良反应 药学监护 

分 类 号：R994.11[医药卫生—毒理学]