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1例47岁女性患者日因发热伴乏力、流涕、咳嗽、咽痛,自行口服对乙酰氨基酚(0.5 g/次)和安乃近(0.25 g/次)治疗,药物服用不规律,每日3～4次,共服用3 d,症状稍缓解。第4天实验室检查:丙氨酸转氨酶(ALT)7247 U/L,天冬氨酸转氨酶(AST)2483 U/L,尿素氮28.3 mmol/L,肌酐630μmol/L,12 h尿量为400 ml。诊断为肝损伤、急性肾衰竭。给予保肝、输注新鲜冰冻血浆、静脉滴注前列腺素E1及持续性肾脏替代治疗。治疗第4天复查,ALT 93 U/L,AST 56 U/L,尿素氮19.1 mmol/L,肌酐166μmol/L,尿量4000 ml/d,患者肝肾功能基本恢复正常。
A 47-year-old female patient had irregular drug intake due to fever with fever, runny nose, cough, sore throat, oral paracetamol (0.5 g / dose) and metamizole (0.25 g / dose) Day 3 to 4 times, taking a total of 3 d, relieve symptoms slightly. Day 4 laboratory tests: alanine aminotransferase (ALT) 7247 U / L, aspartate aminotransferase (AST) 2483 U / L, urea nitrogen 28.3 mmol / L, creatinine 630μmol / L, 12 h urine output was 400 ml. Diagnosis of liver injury, acute renal failure. Give liver protection, infusion of fresh frozen plasma, intravenous infusion of prostaglandin E1 and continuous renal replacement therapy. On the fourth day of treatment, ALT 93 U / L, AST 56 U / L, urea nitrogen 19.1 mmol / L, creatinine 166 μmol / L, urine output 4000 ml / d, liver and kidney function returned to normal.