安神补脑液致肝损伤2例

Liver injury due to Anshen Bunao liquid(安神补脑液):report of 2 cases

2例患者(例1女,49岁;例2女,51岁)均因睡眠不佳自行口服安神补脑液10 ml、2次/d。2例患者均无合并用药。例1和例2分别在服用安神补脑液7和10 d后出现乏力、纳差,实验室检查示丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)分别为1147、1271、215 U/L和805、333、227 U/L。停用安神补脑液并予保肝治疗7 d后,2例患者乏力、纳差等症状得到改善,ALT、AST、ALP分别降至222、396、122 U/L和85、23、129 U/L。例1再次服用安神补脑液,2 d后出现上腹部不适伴呕吐,ALT 409 U/L、AST 339 U/L;停用该药并给予保肝治疗近4个月后,ALT 32 U/L、AST 22 U/L,ALP 89 U/L。例2未再服用该药,出院138天复查,ALT 39 U/L、AST 28 U/L、ALP 130 U/L。

Two patients(patient 1,a 49‑year‑old female;patient 2,a 51‑year‑old female)took Anshen Bunao liquid 10 ml twice daily orally by themselves because of poor sleep.None of the 2 patients had concomitant medications.Patient 1 and patient 2 developed fatigue and poor appetite after 7 and 10 days of Anshen Bunao liquid treatment,respectively.Laboratory tests showed that alanine aminotransferase(ALT),aspartate transaminase(AST),and alkaline phosphatase(ALP)were 1147 U/L,1271 U/L,215 U/L and 805 U/L,333 U/L,227 U/L,respectively.Then Anshen Bunao liquid was stopped and hepatoprotective therapy was given.Seven days later,symptoms of fatigue and poor appetite in the 2 patients were improved,amd laboratory tests showed that the levels of ALT,AST,ALP decreased to 222 U/L,396 U/L,122 U/L and 85 U/L,23 U/L,129 U/L,respectively.Patient 1 took Anshen Bunao liquid again.Two days later,she developed abdominal discomfort with vomiting,ALT was 409 U/L,and AST was 339 U/L.After stopping the drug and giving liver‑protective treatments for nearly 4 months,ALT was 32 U/L,AST was 22 U/L,and ALP was 89 U/L.Patient 2 did not take the drug again.Re-examination after 138 days after discharge,ALT was 39 U/L,AST was 28 U/L,and ALP was 130 U/L.