补骨脂颗粒与驱白巴布期片联用致药物性肝损伤1例

A case of drug-induced liver injury caused by the combined medication of Buguzhi granules and Qubaibabuqi tablets

1例49岁男性患者,因白癜风就诊于某皮肤专科医院,给予口服补骨脂颗粒(10 g,bid),驱白巴布期片(3片,tid)等药物治疗,治疗后第30天实验室检查示:丙氨酸氨基转移酶(ALT)1 858.2 IU·L-1,天门冬氨酸氨基转移酶(AST)740.6 IU·L-1,γ-谷氨酰转移酶56.0 IU·L-1,无乏力,无黄疸及皮肤、黏膜出血,无恶心、呕吐、反酸、烧心,无腹胀、腹痛、呕血、黑便等。治疗后第32天来我院就诊,实验室检查示:ALT 1190 IU·L-1,AST 206 IU·L-1,γ-谷氨酰转移酶52 IU·L-1,当日收入院后给予复方甘草酸苷、复合辅酶、还原型谷胱甘肽等药物保肝治疗后肝功能逐渐好转,入院治疗36 d复查肝功能示:ALT 48 IU·L-1,AST25 IU·L-1,γ-谷氨酰转移酶32 IU·L-1,患者治愈出院。

A 49-year-old male patient with vitiligo visited a dermatological specialist hospital.The patient was treated with Buguzhi granules(10 g,bid)and Qubaibabuqi tablets(3 tablets,tid).After 30 days of the treatment,his liver enzyme levels highly increased.Alanine aminotransferase(ALT)was 1 858.2 IU·L^-1,aspartate aminotransferase(AST)was 740.6 IU·L^-1,andγ-Glutamyl transpeptidase(γ-GT)was 56.0 IU·L^-1.While,he had no symptom of fatigue,jaundice,mucocutaneous hemorrhage,nausea,vomiting,acid regurgitation,heartburn,distension,abdominal pain,melena and hematemesis.Two days later,the patient visited our hospital,and the laboratory examination on admission showed:ALT 1190 IU·L^-1,AST 206 IU·L^-1,γ-GT 52 IU·L^-1.The patient's liver function gradually improved after the hepatoprotective therapy with compound glycyrrhizin,coenzyme complex and reduced glutathione.Thirty-six days after admission,the elevated liver enzyme levels returned to the normal ranges(ALT 48 IU·L^-1,AST 25 IU·L^-1,γ-GT 32 IU·L^-1),and the patient was discharged.