那屈肝素钙注射液致肝损伤  

Liver injury due to nadroparin calcium injection

作　　者：于丽红[1] 赵婷[1] 马文明[1] Yu Lihong;Zhao Ting;Ma Wenming(Department of Clinical Pharmacy,Weifang People′s Hospital,Shandong Province,Weifang 261041,China)

机构地区：[1]潍坊市人民医院临床药学科,潍坊261041

出　　处：《药物不良反应杂志》2022年第7期387-389,共3页Adverse Drug Reactions Journal

摘　　要：1例31岁妊娠女性停经23+1周时因先兆流产给予黄体酮软胶囊0.2 g阴道用、2次/d,那屈肝素钙注射液4100 U皮下注射、1次/d。用药第16天,实验室检查示丙氨酸转氨酶(ALT)766 U/L,天冬氨酸转氨酶(AST)411 U/L,γ-谷氨酰转肽酶(γ-GT)98 U/L,碱性磷酸酶(ALP)180 U/L,总胆汁酸(TBA)40.1μmol/L。考虑为那屈肝素钙引起的肝损伤,停用该药并给予保肝治疗。停用那屈肝素钙第21天,患者出现难免流产,经阴道分娩一死婴,实验室检查示ALT 83 U/L,AST 103 U/L,γ-GT 37 U/L,ALP 157 U/L,TBA 42.0μmol/L。继续给予保肝治疗,停用那屈肝素钙35 d后,实验室检查示ALT 18 U/L,AST 15 U/L,γ-GT 33 U/L,ALP 156 U/L,TBA 6.2μmol/L。A 31-year-old pregnant woman was treated with progesterone soft capsule 0.2 g vaginally twice daily and nadroparin calcium injection 4100 U subcutaneously once daily due to threatened abortion at 23+1 weeks of menopause.On the 16th day of treatments,laboratory tests showed alanine aminotransferase(ALT)766 U/L,aspartate aminotransferase(AST)411 U/L,γ-glutamyl transferase(γ-GT)98 U/L,alkaline phosphatase(ALP)180 U/L,and total bile acid(TBA)40.1μmol/L.Liver injury caused by nadroparin calcium was considered.The drug was stopped and liver protective treatments were given.On the 21st day of nadroparin calcium withdrawal,the patient had inevitable abortion and delivered a dead baby through vagina.Laboratory tests showed ALT 83 U/l,AST 103 U/l,γ-GT 37 U/L,ALP 157 U/L,and TBA 42.0μmol/L.Liver protective treatments were continued After 35 days of nadroparin calcium withdrawal,laboratory tests showed ALT 18 U/L,AST 15 U/L,γ-GT 33 U/L,ALP 156 U/L,and TBA 6.2μmol/L.

关 键 词：肝素 化学和药物性肝损伤 药物相关副作用和不良反应 

分 类 号：R969.3[医药卫生—药理学]