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1例63岁女性患者因患颈椎病、肩周炎自行服用维骨力,每次1粒,2次/d。应用1个月余,共服99粒。患者出现皮肤黄染、尿色深黄,伴乏力、恶心、食欲减退。实验室检查:丙氨酸转氨酶(ALT)322 U/L,天冬氨酸转氨酶(AST)1108 U/L,总胆红素(TBil)133μmol/L,直接胆红素(DBil)85μmol/L。停用维骨力,给予保肝治疗,但黄疸无好转,遂入院。给予腺苷蛋氨酸肠溶片,治疗20 d。患者肝功能:ALT102 U/L,AST89 U/L,TBil604μmol/L,DBil271μmol/L。诊断为重度药物性肝损害。给予血浆置换,并给予门冬氨酸鸟氨酸、熊去氧胆酸和白蛋白等治疗。5个月后,复查肝功能:ALT 21 U/L,AST 50U/L,TBil 134μmol/L,DBil 70μmol/L,患者病情明显好转。
A 63-year-old female patient suffered from cervical spondylosis and frozen shoulder taking vitamin B, 1 capsule twice daily. Application more than 1 month, serving a total of 99. Patients with yellowish skin, dark yellow urine, with fatigue, nausea, loss of appetite. Laboratory tests included: alanine aminotransferase (ALT) 322 U / L, aspartate aminotransferase (AST) 1108 U / L, total bilirubin (TBil) 133 micromol / L, direct bilirubin (85 micromol / L . Disable the vitality, given liver protection, but no improvement in jaundice, then admitted to hospital. Give adenosine methionine enteric-coated tablets for 20 days. Patients with liver function: ALT102 U / L, AST89 U / L, TBil604μmol / L, DBil271μmol / L. Diagnosed with severe drug-induced liver damage. Given plasma exchange, and given aspartate ornithine, ursodeoxycholic acid and albumin treatment. Five months later, the liver function was reviewed: 21 U / L ALT, 50 U / L AST, 134 μmol / L TBil and 70 μmol / L DBil.