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再障治疗过程中常合并有肝功障碍,主要原因有(一)蛋白质同化激素的副作用:该药所致之肝功障碍表现为BSP排出迟延,GOT及GPT升高,CCF、TTT及ZTT降低,这与急性或慢性肝脏损害的改变不同。病检时,光学显微镜下无何异常,电镜下可见毛细胆管扩张及微绒毛(Mic-rovilli)缩短和数量减少。用药前及用药6个月后,GOT及GPT异常例由25%增加到70%左右,LDH异常例由16%增加到33%,Al-phos异常例由22%增加到32%。使用该药治疗再障过程中发现肝功障碍时,首先应考虑与该药有关。肝功障碍的发生率及程度的差异取决于该药的种类,在17α位上有烷基者引起肝功障碍的频率高。很少发生黄疸,虽有也多数程度较轻,减量或停药后能改善。(二)感染:再障时常输新鲜血及血小板血浆,并发乙型肝炎及败血症的机会增多。再障本身颗粒细胞减少,
Aplastic anemia often associated with liver dysfunction, mainly due to (a) the side effects of protein anabolic hormones: the drug-induced liver failure manifested as delayed BSP excretion, GOT and GPT increased, CCF, TTT and ZTT decreased, This is different from changes in acute or chronic liver damage. Disease examination, no abnormal under the optical microscope, electron microscopy can be seen bile duct dilatation and microvilli (Mic-rovilli) shortened and the number of reduced. Before treatment and 6 months after treatment, the abnormalities of GOT and GPT increased from 25% to 70%, the abnormality of LDH increased from 16% to 33%, and the abnormalities of Al-phos increased from 22% to 32%. Use of the drug treatment of aplastic anemia found in the process of liver dysfunction, the first consideration should be related to the drug. The frequency and extent of liver dysfunction depends on the type of drug and the presence of alkyl at position 17α leads to high frequency of liver dysfunction. Jaundice rarely occurs, although most are less severe and can be reduced after weight loss or withdrawal. (B) infection: aplastic anemia often lose new blood and platelet plasma, concurrent hepatitis B and sepsis increased chances. Aplastic anemia itself granulocyte reduction,