静脉应用胺碘酮致急性肝损害六例临床分析

Clinical analysis of intravenous amiodarone induced acute hepatotoxicity in 6 cases

目的分析静脉应用胺碘酮致急性肝损害的临床特点及转归。方法对我院2001年1月至2005年1月静脉应用胺碘酮后致急性肝损害6例患者应用的适应证、剂量、肝损害出现的时间及转归进行分析。结果6例患者出现急性肝损害前静脉应用胺碘酮剂量为290—3000（1322．5±973．8）mg。6例患者用药后（40±29）h肝酶开始升高，天门冬氨酸氨基转移酶（AST）峰值为199—9885（2992±3453）U／L，丙氨酸氨基转移酶（ALT）峰值为247—6750（2583±2402）U／L。停药护肝降酶治疗后（28±17）d肝酶降至正常。结论静脉应用胺碘酮可以导致急性肝损害，应及时监测肝脏功能。

Objective To analyse the clinical characteristics and prognosis of hepatotoxielty by intravenous infusion amiodarone. Methods The primary disease, indications of amiodarone, characteristics of hepatic injury and prognosis of patients were analyzed in 6 cases in FuWai hospital between 2001 January and 2005 January. Results The dosage of intravenous amiodarone was （ 1322. 5 ± 973.8） mg. Patients developed an acute increase in liver enzymes within（40 ± 29）hours of starting intravenous amiodarone for control of tachyarrhythmias. The peak of AST was （2992 ± 3453 ） U/L and ALT was（ 2583 ± 2402） U/L. Discontinuation of amiodarone resulted in a decrease in liver enzyme levels to baseline values within（ 28 ± 17 ）days. Conclusions It is important to identify amiodarone as a potential cause of severe hepatotoxicity. Therefore,it is necessary to monitor liver function after intravenous amiodarone.