论文部分内容阅读
本文报告5例乙胺碘呋酮肝中毒的临床和组织学特征。 5例患者,男4例,女1例,51～73岁。因室性心动过速反复发作,经常规治疗无效或不能耐受而接受乙胺碘肤酮治疗。每日用量为400～800毫克。发生乙胺碘砆酮肝中毒的疗程为2～18个月。 5例乙胺碘呋酮肝中毒患者的临床特点是缺乏与肝有关的症状。2例有轻度至中度的可逆性肝肿大,3例有肝外乙胺碘呋酮现中毒征象;血清转胺酶升高者5例,碱性磷酸酶升高者4例;肝活检:4例示脂肪性变、细胞变性或细胞坏死,提示中毒性肝细胞损害;1例有肉芽肿损伤病变而无脂肪性变,显示过敏性或特异质性损伤。电子显微镜检查,有2例可见充满溶解微粒片状包涵体的磷脂类。
This article reports five cases of amiodarone hepatotoxicity clinical and histological features. 5 patients, 4 males and 1 females, 51 to 73 years old. Due to recurrent ventricular tachycardia, conventional treatment is ineffective or intolerant to treatment with ethylamine. Daily dosage of 400 to 800 mg. Occurrence of ethylamine iodonium ketone liver poisoning course of 2 to 18 months. Five patients with amiodarone hepatotoxicity were clinically characterized by a lack of liver-related symptoms. 2 cases had mild to moderate reversible hepatomegaly, and 3 cases had signs of extrahepatic amiodarone toxicity; 5 cases of elevated serum transaminase, 4 cases of elevated alkaline phosphatase; liver Biopsy: 4 cases of fatty degeneration, cell degeneration or necrosis, suggesting toxic liver cell damage; 1 case of granuloma lesions without fatty changes, showing allergic or specific damage. Electron microscopy, there are two cases of phospholipids can be seen filled with dissolved particulate flaky inclusions.