雷公藤多苷片致急性肝损伤1例分析  

One case of acute liver injury caused by tripterygium glycosides tablets

作　　者：刘宝生 王冠杰 王振华[1] 刘丽红[2] 朱彦[2] 周秀丽 LIU Baosheng;WANG Guanjie;WANG Zhenhua;LIU Lihong;ZHU Yan;ZHOU Xiuli(Department of Clinical Pharmacy,Weifang Hospital of TCM,Weifang Shandong 261000,China;Institute of Information on Traditional Chinese Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Department of Pharmacy,Sunshine Union Hospital,Weifang Shandong 261000,China)

机构地区：[1]潍坊市中医院临床药学科,山东潍坊261000 [2]中国中医科学院中医药信息研究所,北京100700 [3]阳光融和医院药学部,山东潍坊261000

出　　处：《中国药物警戒》2023年第5期511-513,535,共4页Chinese Journal of Pharmacovigilance

基　　金：国家自然科学基金资助项目(82174534,82274684);中国毒理学会临床毒理专项研究课题(CST2019CT307);潍坊高新区科技惠民计划项目(2021KJHM75);潍坊市卫生健康委员会科技项目(WFWSJK2022279)。

摘　　要：目的以病例为基础探讨雷公藤多苷片致急性肝损伤的临床特点、高危因素及治疗方案。方法基于1例应用雷公藤多苷片治疗慢性肾小球肾炎致中药药源性肝损伤的案例进行分析,并结合相关文献进行归纳和讨论。结果1例34岁女性患者因慢性肾小球肾炎,给予雷公藤多苷片20 mg每日3次口服。患者出现谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)升高,停用雷公藤多苷片后给予还原型谷胱甘肽联合异甘草酸镁治疗,患者肝功能指标恢复正常。结论雷公藤多苷片治疗过程中应加强监护患者的临床症状及肝功能生化指标,鉴别可能导致的中药药源性肝损伤,发生肝损伤应及时根据病情给予对应治疗。Objective To investigate the clinical characteristics,high-risk factors and treatment options of acute liver injury caused by tripterygium glycosides tablets on a case-by-case basis.Methods The clinical data on one case of pharmacogenic liver injury caused by tripterygium glycosides tablets used for chronic glomerulonephritis was analyzed based on related literature.Results A 34-year-old female patient with chronic glomerulonephritis was treated with tripterygium glycosides tablets 20 mg orally three times daily.She developed elevated ALT,AST,ALP and GGT before being given reduced glutathione combined with magnesium isoglycyrrhizate after discontinuation of tripterygium glycosides tablets.Her liver function indexes returned to normal after symptomatic treatment.Conclusion The clinical symptoms and biochemical indexes of liver function of patients should be monitored during treatment with tripterygium glycosides tablets to identify the possible pharmacogenic liver injury caused by traditional Chinese medicine.Patients with adverse reactions of liver injury should be given quick and corresponding treatment according to their conditions.

关 键 词：雷公藤多苷片 药源性肝损伤 药品不良反应 病例分析 

分 类 号：R994.11[医药卫生—毒理学]