盘龙七片致肝损伤  

Liver injury induced by Panlongqi tablets(盘龙七片)

作　　者：徐智宇[1] 董至恒 张爱武[1] Xu Zhiyu;Dong Zhiheng;Zhang Aiwu(Department of Pharmacy,the Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院药学部,呼和浩特010050

出　　处：《药物不良反应杂志》2024年第8期504-506,共3页Adverse Drug Reactions Journal

基　　金：国家自然科学基金(82160703);内蒙古自治区自然科学基金(2020MS08106)。

摘　　要：1例67岁女性患者因腰肌劳损给予盘龙七片4片/次口服、3次/d。用药3 d后出现恶心、纳差,继而排浓茶色尿、陶土色便。用药15 d后,患者皮肤、巩膜黄染,全身皮肤瘙痒。实验室检查示丙氨酸转氨酶(ALT)304 U/L,天冬氨酸转氨酶(AST)168 U/L,碱性磷酸酶(ALP)463.6 U/L,G‑谷氨酰转移酶(GGT)1332.3 U/L,总胆红素(TBil)110.5μmol/L,直接胆红素(DBil)92.3μmol/L。排除病毒性肝炎和胆道梗阻后,诊断为药物性肝损伤。停用盘龙七片,给予异甘草酸镁、多烯磷脂酰胆碱、熊去氧胆酸、甲泼尼龙治疗。患者不适症状逐步减轻,肝功能逐步好转。治疗14 d后行彩色多普勒超声下经皮肝脏穿刺活检术,诊断为急性淤胆型肝炎伴汇管区轻度纤维化,考虑药物所致。治疗16 d后,改为保肝药口服2周。停止治疗1周后,患者无不适,皮肤、巩膜颜色正常,肝功能正常(ALT 31 U/L,AST 25 U/L,ALP 83.9 U/L,GGT 37.0 U/L,TBil 19.8μmol/L,DBil 7.3μmol/L)。A 67‑year‑old female patient was treated with oral 4 Panlongqi tablets thrice daily for strain of lumbar muscles.The patient developed nausea and poor appetite after 3 days of administration,followed by discharging strong brown urine and clay‑colored stools.After 15 days of using the drug,she developed yellow staining of the skin and sclera,and itching appeared throughout the body.Laboratory tests showed alanine aminotransferase(ALT)304 U/L,aspartate aminotransferase(AST)168 U/L,alkaline phosphatase(ALP)463.6 U/L,gamma glutamyltransferase(GGT)1332.3 U/L,total bilirubin(TBil)110.5μmol/L,and direct bilirubin(DBil)92.3μmol/L.After excluding viral hepatitis and biliary obstruction,drug‑induced liver injury was diagnosed.Panlongqi tablets were stopped,and magnesium isoglycyrrhizinate,polyene phosphatidylcholine,ursodeoxycholic acid,and methylprednisolone were given.The patient′s discomfort symptoms were gradually eased and liver function was gradually improved.After 14 days of treatments,percutaneous liver biopsy under color doppler ultrasound was performed,and she was diagnosed as acute cholestatic hepatitis with mild fibrosis in the portal area,possibly caused by drug.After 16 days of treatments,the medication was switched to oral hepatoprotective drugs for 2 weeks.One week after stopping treatments,the patient had no discomfort and the color of skin and sclera was normal.The liver function was normal,showing ALT 31 U/L,AST 25 U/L,ALP 83.9 U/L,GGT 37.0 U/L,TBil 19.8μmol/L,and DBil 7.3μmol/L.

关 键 词：乌头碱 化学和药物性肝损伤 中药 盘龙七片 

分 类 号：R969[医药卫生—药理学]