一例慢性乙肝患者服用替比夫定片致线粒体肌病的分析

Analysis of a case of mitochondrial myopathy caused by Telbivudine tablets in patient with chronic hepatitis B

1例患慢性乙型病毒性肝炎10余年患者,每日服替比夫定片每次600 mg,7个月后出现上腹不适、恶心、呕吐,伴肌痛。入院检查检验结果示:肌痛NRS评分3分,尿酸930μmol/L,肌酸激酶1 376 IU/L,考虑药物相关线粒体肌病。停用替比夫定片,给予水化、碱化及口服辅酶Q10片治疗,腹部不适、恶心、呕吐及肌痛较前缓解,NRS评分1分,测得尿酸695μmol/L、肌酸激酶773 IU/L后出院。

One case of patient with chronic hepatitis B in more than 10 years,take Telbivudine tablets 600 mg once daily,abdominal discomfort,nausea,vomiting,and myalgia occurred after 7 months of medication.Inspection results of admission were as follow:myalgia NRS score was 3,uric acid 930μmol/L,creatine kinase 1 376 IU/L.Drug related mitochondrial myopathy was considered.Telbivudine tablets was stopped,and the patient was treated by hydration therapy,alkalization therapy,and oral coenzyme Q10 tablets.The abdominal discomfort,nausea,vomiting and myalgia were relieved,the NRS score was 1,uric acid 695 mol/L,creatine kinase 773 IU/L.Then the patient was discharged from hospital.