对1例老年患者使用多种药物致肝功能损害的用药分析

Medication Analysis of Liver Dysfunction Aggravation Induced by Multiple Drug Use in an Elderly Patients

本文对l例患有慢性阻塞性肺疾病伴有急性加重的老年女性患者因使用多种药物而致肝功能损害的情况进行因果关系分析。患者在住院期间可能由于口服阿托伐他汀钙、左氧氟沙星导致丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)异常升高,经停药并予以还原型谷胱甘肽、多烯磷脂酰胆碱和异甘草酸镁等保肝治疗后,ALT和AST逐渐降低,后正常,好转出院。阿托伐他汀钙和左氧氟沙星应慎用于老年患者,尤其是原有肝功能损害者,同时应定期监测患者肝功能。

Reason for hepatic function aggravation in an elderly female with acute exacerbanon ot cnromc obstructive pulmonary disease was analyzed. Drugs which might damage alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were used including atorvastatin calcium and levofloxacin. These two drugs were withdrawed immediately, and hepatoprotective drugs including glutathione, polyenephosphatidyl choline and isoglycyrrhizinic acid magnesiumwere administered. The values of ALT and AST reduced gradually and recovered to normal, and the patient was discharged with improvement. Atorvastatin calcium and levofloxacin should be prescribed to elderly patients with caution, especially to the patients with original liver damage. At the same time, liver function should be monitored regularly in these patients.