1例静滴阿奇霉素致急性肝损伤的病例报道

A case report of acute liver injury induced by intravenous infusion of azithromycin

目的探讨静滴阿奇霉素致急性肝损伤的发病原因,为该病的防治提供依据。方法本研究中的1例急性肝损伤(肝细胞型、重度)的病例,既往否认肝病病史,检查结果排除各型肝炎及自身免疫性肝病,症状出现前2周曾静脉使用阿奇霉素6 d,随予以保肝、利胆、退黄等治疗。结果治疗8 d后,患儿症状消失;随访3个月,患儿肝功能正常,无临床症状。结论阿奇霉素可导致肝损伤,临床上应根据患儿年龄、用药途径、用药时间安全、合理地使用阿奇霉素,保障患儿的用药安全,避免药物性肝损伤(DILI)发生。

Objective To investigate the causes of acute liver injury induced by intravenous infusion of azithromycin,and to provide basis for the prevention and treatment of the disease.Methods A case of acute liver injury(hepatocyte type,severe)occurred in this study,the previous history of liver disease was denied.All types of hepatitis and autoimmune liver disease were excluded from the examination results.Azithromycin was given intravenously for 6 days at 2 weeks before the symptoms appeared,and then the children were treated with liver protection,cholagogue and removing jaundice.Results After 8 days of treatment,the symptoms of children disappeared;after 3 months of follow-up,the liver function of children was normal and no clinical symptoms were found.Conclusion Azithromycin can lead to liver injury,it should be used safely and reasonably according to children's age,medication route and medication time,so as to ensure the medication safety of children and avoid drug induced liver injury(DILI)in clinic.