摘要
1例35岁男性,因慢性乙型肝炎口服阿德福韦10 mg/d治疗。3个月后肝功能恢复正常,15个月后HBV DNA<1×103拷贝/ml,但HBeAg仍呈阳性。治疗2年,患者自行停药。停药40 d后,出现乏力和食欲不振,实验室检查显示ALT1 884.9U/L,AST1 135.4 U/L,TBil 42.8μmol/L,DBil 16.8μmol/L,HBV DNA1.27×107拷贝/ml。考虑为阿德福韦停药所致的病毒学反弹。入院后给予恩替卡韦1 mg/d及保肝对症治疗。但患者的症状逐渐加重,黄疸加深。实验室检查显示TBil 428μmol/L,PTA13.8%,INR 5.8。诊断为肝衰竭。尽管给予非生物型人工肝治疗及血浆置换,但患者病情进一步恶化,出现肝性脑病,终因肝衰竭死亡。
A 35-year-old man with chronic hepatitis B took adefovir 10 mg/day. Three months later, his liver function returned to normal ： fifteen months later, his HBV DNA level was 〈 1 × 10^3 copies/ml. However, his HBeAg was still positive. After two years of treatment, adefovir was withdrawn by himself. After forty days of adefovir discontinuation, the man developed fatigue and anorexia. Laboratory testing showed the following results： ALT 1 884.9 U/L, AST 1 135.4 U/L, TBil 42.8 μmol/L, DBil 16.8 μmol/L, HBV DNA 1.27 × 10^7 copies/ml. Viral rebound due to adefovir withdrawal was suspected. Subsequently he was admitted to hospital and given oral entecavir 1 mg/day and llver-protective and symptomatic therapy. However, the patient＇s symptoms became aggravated gradually, and deepening jaundice occurred. Laboratory investigations revealed the following values ： TBil 428 μmoL/L, PTA 13.8%, INR 5.8. He was diagnosed with hepatic failure. Despite treatment with non-biotype artificial liver and plasmapheresis, his condition deteriorated further, and hepatic encephalopathy occurred. Finally he died of hepatic failure.
出处
《药物不良反应杂志》
2008年第4期289-290,共2页
Adverse Drug Reactions Journal
关键词
阿德福韦
停药反应
肝衰竭
不良反应
adefovir
withdrawal response
hepatic failure
adverse reaction
