埃索美拉唑相关药物性肝损害

Drug-induced hepatic injury associated with esomeprazole

1名54岁女性患者,因十二指肠球部溃疡口服埃索美拉唑20mg,1次/d、吉法酯50mg,3次/d、铝碳酸镁500mg,3次/d。服药近半月后逐渐出现食欲减退、尿色加深,继续服用1月余后出现巩膜黄染、伴皮肤瘙痒。门诊检查肝功能示:AST890U/L,ALT1123U/L,ALP204U/L,γ-GT277U/L,TBil169.7μmol/L,DBil99.7μmol/L,IBil70.0μmol/L,TBA234.6μmol/L。入院后停用埃索美拉唑,给予还原型谷胱甘肽和硫普罗宁治疗,1周后患者巩膜黄染逐渐消退,尿色恢复正常,3周后复查肝功能,明显好转出院。

A 54-year-old woman with duodenal bulb ulcer took esomeprazole 20 mg once daily, gefarnate 50 mg thrice daily, and hydrotalcite 500 mg thrice daily. Nearly half a month later, she developed anorexia and dark urine gradually. After another one month, she developed yellowish of sclera and pruritus. At out-patient department, her liver function examination showed the following values： AST 890 U/L, ALT 1 123 U/L, ALP 204 U/L, γ-GT 277 U/L, TBil 169.7 μmol/L, DBil 99.7 μmol/L, IBil 70.0 μmol/L,TBA 234.6 μmol/L. Esomeprazole was discontinued after admission, and the patient was treated with reduced glutathione and tiopronin. One week later, the patient＇s yellowish of sclera resolved gradually and urine color returned to normal. On reexamination 3 weeks later, her liver function markedly improved, and then she was discharged from the hospital.