肠外营养致肝损伤  

Liver injury induced by parenteral nutrition

作　　者：程秀丽 蒋庆军 胡进 Cheng Xiuli;Jiang Qingjun;Hu Jin(Department of Pharmacy,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750000,China;Department of Cardiology,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750000,China;Preparation Center,General Hospital of Ningxia Medical University,Yinchuan 750001,China)

机构地区：[1]宁夏回族自治区人民医院药学部,银川750000 [2]宁夏回族自治区人民医院心内科,银川750000 [3]宁夏医科大学总医院制剂中心,银川750001

出　　处：《药物不良反应杂志》2022年第10期551-553,共3页Adverse Drug Reactions Journal

基　　金：宁夏回族自治区自然科学基金(2022AAC03601);宁夏医科大学校级课题(XM2019052)。

摘　　要：1例54岁女性主动脉夹层患者因存在营养不良风险,接受脂肪乳氨基酸(17)葡萄糖(11%)注射液1440 ml静脉滴注、1次/d,复方氨基酸注射液(18AA‑II)250 ml静脉滴注、1次/d,中长链脂肪乳注射液(C6‑24)250 ml静脉滴注、1次/d,其他治疗包括维持血压和控制心率的药物、镇痛剂、10%氯化钾注射液等。治疗前实验室检查示丙氨酸转氨酶(ALT)36 U/L,天冬氨酸转氨酶(AST)35 U/L,γ‑谷氨酰转肽酶(γ‑GT)51 U/L、总胆红素(TBil)8.3μmol/L、碱性磷酸酶(ALP)129 U/L。肠外营养治疗第8天实验室检查示ALT 343 U/L、AST 357 U/L、γ‑GT 343 U/L、TBil 21.4μmol/L、ALP 376 U/L,考虑为肠外营养导致的肝损伤。停止肠外营养,继续其他治疗,并予谷胱甘肽联合二氯醋酸二乙胺进行保肝治疗。停止肠外营养8 d后实验室检查示ALT 42 U/L、AST 29 U/L、γ‑GT 55 U/L、TBil 8.4μmol/L、ALP 107 U/L。A 54‑year‑old female patient with aortic dissection received parenteral nutrition treatments due to malnutrition risk,including IV infusions of fat emulsion amino acid(17)and glucose(11%)injection 1440 ml once daily,compound amino acid injection(18 AA‑II)250 ml once daily,and medium and long chain fat emulsion injection(C6‑24)250 ml once daily.Other treatments included drugs to maintain blood pressure and control heart rate,analgesics,10%potassium chloride injection,etc.The laboratory tests before treatments showed alanine aminotransferase(ALT)36 U/L,aspartate aminotransferase(AST)35 U/L,γ‑glutamyl transpeptidase(γ‑GT)51 U/L,total bilirubin(TBil)8.3μmol/L,and alkaline phosphatase(ALP)129 U/L.After 8 days of parenteral nutrition treatments,laboratory tests showed ALT 343 U/L,AST 357 U/L,γ‑GT 343 U/L,TBil 21.4μmol/L,and ALP 376 U/L.The liver injury caused by parenteral nutrition was considered.Parenteral nutrition was stopped,other treatments were continued,and liver‑protective treatments such as glutathione combined with diethylamine dichloroacetate were given.Eight days later,the laboratory test showed ALT 42 U/L,AST 29 U/L,γ‑GT 55 U/L,TBil 8.4μmol/L,and ALP 107 U/L.

关 键 词：胃肠外营养 脂肪乳剂 静脉注射用 化学性和药物性肝损伤 

分 类 号：R575[医药卫生—消化系统]