硫普罗宁致脂肪肝患者肝酶水平升高

Increased liver enzyme levels after tiopronin administration in a patient with fatty liver

1例48岁女性患者,因脂肪肝伴肝酶水平轻度升高(ALT54.2 U/L)口服硫普罗宁0.2 g,3次/d。服该药8 d后出现乏力、纳差,尿略发黄等症状。实验室检查:ALT562.1 U/L,AST253.9 U/L,DBil 26.2μmol/L,TBil 38.3μmol/L。甲、丙、丁、戊型肝炎病毒学检测均阴性。立即停用硫普罗宁,给予异甘草酸镁和脱氧核苷酸钠静脉滴注等。之后,患者肝功能逐渐好转。出院18 d后患者ALT为27.1 U/L,AST为19.1 U/L。

A 48-year-old woman with fatty liver and miht increase in liver enzyme level （ ALT 54.2 U/L） was treated with tiopronin 0. 2 g thrice daily. Eight days later, the patient developed asthenia, anorexia, and yellowish urine. Laboratory testing revealed the following values： ALT 562.1 U/L, AST 253.9 U/L, DBil 26.2 μmol/L, TBil 38.3 μmol/L. Serology tests for hepatitis A, C, D, E viruses were negative. Tiopronin was withdrawn immediately and an IV infusion of magnesium isoglycyrrhizinate and sodium deoxyribonucleutide was given. Subsequently, her liver function improved gradually. Eighteen days after discharge, her ALT was 27.1 U/L and her AST was 19.1 U/L.