乳癖消胶囊致肝损伤

Liver injury induced by Rupixiao capsules(乳癖消胶囊)

1例41岁女性患者因乳腺增生口服乳癖消胶囊1.6 g(5粒)、3次/d。约30 d后,患者出现恶心、尿黄和皮肤、巩膜黄染。继续服药约20 d,症状加重,自行停用乳癖消胶囊。停药10 d后,症状无改善。实验室检查:丙氨酸转氨酶(ALT)1234 U/L,天冬氨酸转氨酶(AST)778 U/L,γ‑谷氨酰转移酶(γ‑GT)174 U/L,碱性磷酸酶(ALP)156 U/L,总胆红素(TBil)78.7μmol/L,总胆汁酸(TBA)45.4μmol/L。经实验室与辅助检查排除其他原因导致的肝损伤,诊断为药物性肝损伤,考虑与乳癖消胶囊有关。给予还原型谷胱甘肽、多烯磷脂酰胆碱、复方甘草酸苷、丁二磺酸腺苷蛋氨酸及双环醇等治疗。患者恶心、尿黄、黄疸症状逐渐消退。治疗35 d后复查:ALT 39 U/L,AST 43 U/L,γ‑GT 57 U/L,ALP 85 U/L,TBil 17.3μmol/L,TBA 14.3μmol/L。

A 41-year-old female patient received Rupixiao capsules 1.6 g thrice daily for hyperplasia of mammary glands.About 30 days later,the patient developed nausea,dark urine,and yellowish skin and sclera.After 20 days of continued treatment,her symptoms worsened,so she stopped using Rupixiao capsules by herself.After 10 days of drug withdrawal,her symptoms were not improved.The laboratory tests showed alanine aminotransferase(ALT)1234 U/L,aspartate aminotransferase(AST)778 U/L,gamma-glutamyltransferase(γ-GT)174 U/L,alkaline phosphatase(ALP)156 U/L,total bilirubin(TBil)78.7μmol/L,and total bile acid(TBA)45.4μmol/L.After excluding liver injury caused by other reasons through laboratory and auxiliary examination,drug-induced liver injury was diagnosed,which was considered to be related to Rupixiao capsules.Drugs such as reduced glutathione,polyene phosphatidylcholine,compound glycyrrhizin,ademetionine 1,4-butanedisulfonate,and bicyclol were given.The patient′s symptoms of nausea,yellow urine,and jaundice gradually subsided.After 35 days of treatments,laboratory tests showed ALT 39 U/L,AST 43 U/L,γ-GT 57 U/L,ALP 85 U/L,TBil 17.3μmol/L,and TBA 14.3μmol/L.