胃刻宁片致急性肝损伤

Acute liver injury induced by Weikening tablets(胃刻宁片)

1例58岁男性患者因胃溃疡自行口服胃刻宁片1.24 g、3次/d,同期未合并服用其他药物。1个月后患者出现腹胀、巩膜黄染、尿液发黄和乏力等症状,实验室检查示丙氨酸转氨酶(ALT)1272 U/L,天冬氨酸转氨酶(AST)507 U/L,总胆红素(TBil)59μmol/L,直接胆红素(DBil)34μmol/L。考虑为胃刻宁片导致的急性肝损伤。停用该药,予以保肝、利胆、降酶等治疗。10 d后,患者上述症状消失,肝功能检查示ALT 163 U/L、AST 43 U/L、TBil 23μmol/L、DBil 17μmol/L;1个月后,患者肝功能检查示ALT 31 U/L、AST 24 U/L、TBil 14μmol/L、DBil 6μmol/L。考虑患者的肝损伤可能与胃刻宁片所含的白屈菜有关。

A 58-year-old male patient took Weikening tablets 1.24 g thrice daily orally for gastric ulcer by himself.The patient did not take other drugs during the same period.After 1 month of medication,the patient developed the symptoms such as abdominal distension,yellowish sclera,yellowish urine,and fatigue.Laboratory tests showed alanine aminotransferase(ALT)1-272 U/L,aspartate aminotransferase(AST)507 U/L,total bilirubin(TBil)59-μmol/L,and direct bilirubin(DBil)34-μmol/L.Acute liver injury caused by Weikening tablets was considered.Then the drug was stopped and treatments such as liver protective,choleretic,and enzyme reduction drugs were given.Ten days later,the above symptoms disappeared,and the liver function reexamination showed ALT 163-U/L,AST 43-U/L,TBil 23-μmol/L,and DBil 17-μmol/L.One month later,the patient′s liver function test showed ALT 31-U/L,AST 24-U/L,TBil 14-μmol/L,and DBil 6-μmol/L.It was considered that the liver injury of the patient may be related to greater celandine contained in Weikening tablets.