对乙酰氨基酚致婴儿肝损伤1例药学监护并文献复习

Pharmaceutical Care of One Case of Liver Injury Induced by Acetaminophen in Infant and Literature Review

目的:探讨对乙酰氨基酚(APAP)致婴儿肝损伤的药学监护及有效治疗方法,初步分析APAP引起的肝损伤与相关药物基因的关系。方法:临床药师进行药学监护,分析1例婴儿使用APAP混悬滴剂(泰诺林)治疗后出现急性肝损伤的临床资料,并结合相关文献进行讨论。结果:该患儿出现肝损伤后,使用还原型谷胱甘肽保肝、血浆置换解毒,最终患儿的肝损伤症状明显好转。经过检测药物相关的HLA基因,发现APAP导致的肝损伤可能与HLA-B*1502基因阳性有关。结论:APAP导致的肝损伤是临床常见不良反应,患儿用药后应监测肝功能,必要时给予对症治疗。同时,对出现肝损伤的婴儿应加强检测药物相关基因,避免不良发应再次发生。

Objective： To explore the effective treatments to liver injury induced by acetaminophen in infant and preliminary analyze the genes related to the drug-induced liver injury. Methods： The clinical data of one infant of acute liver injury induced by acetaminophen were reviewed retrospectively. Results： Reduced glutathione and plasma exchange were administered to this infant with liver injury. A good prognosis was observed following these treatments. Besides,liver injury caused by acetaminophen may be associated with HLA-B＊ 1502. Conclusion： Liver injury induced by acetaminophen is common in clinical practice. The indicators of liver function should be monitoring when children are treated with acetaminophen. The principal medical treatments for the subsequent symptoms are necessary as well as genetic testing of acetaminophen.