1例阿昔洛韦致药物性肝损伤患儿的药学监护  

Pharmaceutical Care for a Child with Drug-Induced Liver Injury Induced by Acyclovir

作　　者：张文[1] 蒋莉[1] 周后凤[1] 干小红[1] ZHANG Wen;JIANG Li;ZHOU Houfeng;GAN Xiaohong(Chengdu Fifth People′s Hospital,Chengdu,Sichuan,China 611130)

机构地区：[1]四川省成都市第五人民医院,四川成都611130

出　　处：《中国药业》2022年第6期114-117,共4页China Pharmaceuticals

基　　金：中国药学会全国医药信息网科普研究项目[CMEI2021KPYJ00465]。

摘　　要：目的探讨临床药师在药物性肝损伤临床治疗中发挥的作用。方法临床药师参与1例阿昔洛韦致肝功能损伤传染性单核细胞增多症患儿的临床诊疗过程,评估肝损伤程度和类型,结合相关指南及文献,综合患儿肝损伤的特征和用药史,并结合因果关系评价量表(RUCAM评分系统)进行量化评估,判断引起肝损伤的药物,建议停用可疑药物,调整保肝药物。结果临床药师判断阿昔洛韦致可疑性药物肝损伤的可能性大,为肝细胞损伤型,急性,RUCAM 8分(很可能),严重程度2级。并参考相关指南,为临床提供了合理的用药方案,患儿症状缓解,出院。结论临床药师可多环节参与药物性肝损伤患儿的临床诊疗,发挥药学专业优势,优化治疗方案。Objective To investigate the role of clinical pharmacists in the treatment of drug-induced liver injury(DILI).Methods Clinical pharmacists participated in the clinical diagnosis and treatment process of a child case with liver injury infectious mononucleosis(IM),the degree and type of liver injury were assessed.Based on the related guidelines and literature,combined with features and medication history of liver injury of the child case and quantitative assessment that conducted with roussel uclaf causality assessment method(RUCAM scoring system),clinical pharmacists can judge drugs which induced liver damage,stop the use of suspicious drugs and adjust the use of medicine for protecting liver.Results Suspicious drug liver injury was highly likely caused by acyclovir through the judgement by clinical pharmacists,which was judged as acute,hepatocellular injury with severity at level 2,eight points for RUCAM(high probability).Clinical pharmacists provided a reasonable medication plan for the clinic based on the related guidelines for the child case’s recovered well and discharged from hospital.Conclusion Clinical pharmacists can participate in the clinical diagnosis and treatment of DILI in multiple links,in which they should give full play to the advantages of pharmacy profession and optimize treatment regimens.

关 键 词：临床药师 药物性肝损伤 阿昔洛韦 药学监护 小儿 

分 类 号：R95[医药卫生—药学] R978.7