生食黄独零余子致肝损伤  

Liver injury caused by raw Dioscorea bulbifera L.

作　　者：王焱 费媛媛 姬会春 Wang Yan;Fei Yuanyuan;Ji Huichun(Department of Infection,Suqian First People′s Hospital,Jiangsu Province,Suqian 223800,China;Department of Infection,Wuxi No.5 People′s Hospital,Jiangsu Province,Wuxi 214000,China)

机构地区：[1]宿迁市第一人民医院感染科,宿迁223800 [2]无锡市第五人民医院感染科,无锡214000

出　　处：《药物不良反应杂志》2022年第1期37-39,共3页Adverse Drug Reactions Journal

摘　　要：1例34岁女性患者为治疗鼻炎自行间断生食黄独零余子7或8个,间隔1年后再次生食黄独零余子1个,4 d后患者出现恶心及皮肤、巩膜黄染。实验室检查:丙氨酸转氨酶(ALT)732 U/L,天冬氨酸转氨酶(AST)597 U/L,γ-谷氨酰转移酶(γ-GT)204 U/L,碱性磷酸酶(ALP)202 U/L,总胆红素(TBil)203.7μmol/L,直接胆红素(DBil)122μmol/L。腹部磁共振检查示早期肝硬化,肝脏瞬时弹性成像示早期肝纤维化;经实验室各项检查可排除病毒性肝炎、自身免疫性肝炎、肝豆状核变性、铁代谢异常等其他原因导致的肝损伤,考虑本例患者的肝损伤与黄独零余子有关。给予异甘草酸镁注射液、多烯磷脂酰胆碱注射液、注射用还原型谷胱甘肽和注射用丁二磺酸腺苷蛋氨酸和熊去氧胆酸等保肝药物治疗,42 d后,患者症状基本消失,实验室检查示TBil 55.3μmol/L,DBil 18.1μmol/L,ALT 24 U/L,AST 25 U/L,γ-GT 44 U/L,ALP 124 U/L。A 34-year-old female patient intermittently ate 7 or 8 raw Dioscorea bulbifera L.due to rhinitis.After a 1-year interval,she ate 1 raw Dioscorea bulbifera L.again.Four days later,the patient developed nausea and yellowish skin and sclera.Laboratory tests showed alanine aminotransferase(ALT)732 U/L,aspartate aminotransferase(AST)597 U/L,gamma glutamine transferase(γ-GT)204 U/L,alkaline phosphatase(ALP)202 U/L,total bilirubin(TBil)203.7 mmol/L,and direct bilirubin(DBil)122 mmol/L.Abdominal magnetic resonance imaging showed early liver cirrhosis,and liver transient elastography showed early liver fibrosis.The liver injury caused by viral hepatitis,autoimmune hepatitis,hepatolenticular degeneration,abnormal iron metabolism and other reasons was excluded by various laboratory examinations.It was considered that the liver injury was associated with Dioscorea bulbifera L.Then liver-protective drugs such as magnesium isoglycyrrhizinate injection,polyene phosphatidylcholine injection,reduced glutathione for injection,ademetionine 1,4-butanedisulfonate for injection,and ursodeoxycholic acid were given.Forty-two days later,the patient′s symptoms disappeared basically and laboratory tests showed TBil 55.3 mmol/L,DBil 18.1 mmol/L,ALT 24 U/L,AST 25 U/L,γ-GT 44 U/L,and ALP 124 U/L.

关 键 词：薯蓣属 植物中毒 化学和药物性肝损伤 肝硬化 黄独零余子 

分 类 号：R285.6[医药卫生—中药学]