阿苯达唑致广州管圆线虫病患者肝损害的临床分析

Clinical analysis on acute hepatic injury induced by albendazole in patients with angiostrongyliasis cantonensis

目的分析口服阿苯达唑治疗广州管圆线虫病致急性肝损害作用。方法对41例广州管圆线虫病患者接受阿苯达唑治疗后出现的急性肝损害(肝功能变化)、基础疾病及转归进行分析。结果1)用阿苯达唑治疗广州管圆线虫病疗程结束后,26例患者丙氨酸氨基转移酶(ALT)升高,范围为42.00～252.00U/L,平均(97.66±56.66)U/L;9例患者天门冬氨酸氨基转移酶(AST)增高,范围为41.00～131.00U/L,平均(60.66±29.34)U/L;13例患者γ-谷氨酰转移酶(GGT)升高,范围为56.90～213.00U/L,平均(99.52±46.65)U/L;碱性磷酸酶(ALP)、蛋白质及胆红素水平未见显著变化;2)阿苯达唑治疗过程中,同时加用保肝药物(甘利欣、肝泰乐)组68.42%(13/19)氨基转移酶升高,未使用保肝药物组59.09%(13/22)氨基转移酶升高,差异无统计学意义(P>0.05);3)肝功异常者停用阿苯达唑后开始出现好转,出院2个月后血清氨基转移酶大多恢复至正常水平。结论口服阿苯达唑可导致急性肝损害,其剂量须根据患者具体情况进行调整,临床应用时注意监测肝功能,并合理使用保肝药物。

Objective To analyze the acute hepatic injury induced by albendazole in patients with angiostrongyliasis cantonensis. Methods The characteristics of hepatic injury, primary disease and prognosis of patients were determined in 41 angiostrongyliasis cantonensis cases. Results 1） After treatment of albendazole, ALT was increased from 42.00- 252.00 U/L[（97. 66±56.66）U/L] in 12 cases, AST was heightened to （60. 66±29.34） U/L in 9 cases, GGT were risen in 13 cases, raning from 56.90-213 U/L [（99.52±46.65） U/L], but ALP, protein and bilirubin didn＇t have significant difference; 2） During treatment of Albendazole, 68.42 % （13/19） patients＇ ALT level heightened in the group of taking liver protecting medicine （diammonium glycyrrhizinate and glucurolactone）, 59. 09% （13/22）patients＇ ALT level heightened in the group of non-taking liver protecting medicine. The two group didn＇t have significant difference （P〉 0.05） ; 3） Patients＇ liver function recovered after stop using albendazole, 2 months after leaving hospital, all the transaminase level decreased to normal. Conclusion Acute hepatic injury can be induced by albendazole. The dose should be adjusted by the condition of the patients. The clinicians should attach importance to liver function, and reasonable use of liver protecting medicine.