土三七致肝损伤合并肝小静脉闭塞病1例并文献复习

One Case of Gynura-induced Liver Injury Complicated with Hepatic Veno-occlusive Disease and Literature Review

目的探讨1例血吸虫肝病患者服用土三七制剂致药物性肝损伤合并肝小静脉闭塞病。通过回顾此病例,加强临床医师对药物性肝损伤的警惕性。方法回顾、梳理该病例并结合相关文献进行总结分析。结果在排除病毒性肝炎及既往血吸虫肝病复发以及相关消化道肿瘤可能,结合患者用药史及相关检查结果诊断为药物性肝损伤合并肝小静脉闭塞病,经积极治疗后患者顺利康复。结论对于肝功能异常的相关病例诊断,临床医师对于病毒性肝炎、自身免疫性肝炎等警惕性很高,但药物性肝损害仍需抽丝剥茧,细致的病史采集对诊断至关重要。

Objective To investigate a case of schistosomiasis liver disease with drug-induced liver injury combined with hepatic veno-occlusive disease after taking gynura.By reviewing this case,clinicians should be more vigilant against drug-induced liver injury.Methods The case was reviewed and analyzed based on relevant literature.Results After ruling out the possibility of viral hepatitis,recurrence of schistosoma liver disease and related gastrointestinal tumors,the patient was diagnosed as drug-induced liver injury complicated with hepatic veno-occlusive disease based on medication history and related examination results.After active treatment,the patient recovered smoothly.Conclusion For the diagnosis of related cases of abnormal liver function,clinicians are highly alert to viral hepatitis and autoimmune hepatitis.However,drug-induced liver injury still needs to be detailed,and meticulous history collection is crucial for diagnosis.