大剂量甲泼尼龙相关性肝损伤的评价与分析  

Evaluation and analysis of high-dose methylprednisolone associated liver injury

作　　者：范晓良 袁玉梅[2] 楼亚玲[2] 王建琴 沈黎岚 钟涛 FAN Xiaoliang;YUAN Yumei;LOU Yaling;WANG Jianqin;SHEN Lilan;ZHONG Tao(Jiaxing Hospital of TCM Affiliated Zhejiang Chinese Medical University,Jiaxing 314001,China;Huzhou Central Hospital,Zhejiang Province,Huzhou 313000,China)

机构地区：[1]浙江中医药大学附属嘉兴中医院,嘉兴314001 [2]浙江省湖州市中心医院,湖州313003

出　　处：《中国临床药学杂志》2023年第2期126-130,共5页Chinese Journal of Clinical Pharmacy

摘　　要：目的 为大剂量甲泼尼龙(≥500 mg)冲击治疗提供临床安全用药参考。方法 通过回顾性分析神经内科近2年5例大剂量甲泼尼龙冲击治疗引起的相关性肝损伤病例,以RUCAM量表评估药物性肝损伤的可能性,Naranjo’s评分量表评估不良反应事件关联性。结果 该5例肝损伤患者由甲泼尼龙引起的可能性较高,根据Naranjo’s评分该5例患者均为很可能,其中4例为轻度的肝酶升高,1例为重度肝功能异常,分析其原因可能与甲泼尼龙冲击治疗的用量、疾病差异等有关。结论 大剂量甲泼尼龙冲击治疗可能引起肝损伤,在激素冲击治疗时,建议定期评估患者肝功能。AIM To provide reference for clinical safety of high-dose methylprednisolone( ≥ 500 mg) pulse therapy.METHODS Totally 5 patients with liver injury caused by high-dose methylprednisolone pulse therapy in the department of neurology of our hospital in recent two years were retrospectively analyzed.The possibility of drug-induced liver injury was assessed by Roussel Uclaf causality assessment method(RUCAM) scale,and the correlation of adverse reaction events was assessed by Naranjo's scale.RESULTS The 5 patients with liver injury were more likely to be caused by methylprednisolone.According to Naranjo's score,all the patients were probable.Among them,4 patients showed mild elevation of liver enzymes,and 1 patient showed severe liver dysfunction.The reason might be related to the dosage of methylprednisolone and the difference of disease.CONCLUSION High-dose methylprednisolone pulse therapy may cause liver injury,so it is necessary to regularly evaluate the effect of high-dose glucocorticoid on patients' liver function during pulse therapy.

关 键 词：大剂量 甲泼尼龙 肝损伤 视神经脊髓炎 吉兰-巴雷综合征 

分 类 号：R969.3[医药卫生—药理学]