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1例34岁女性因慢性盆腔炎服用0.5g金刚藤胶囊4粒,3次/d;丹莪妇康煎膏10g,2次/d。患者既往无药物过敏史及慢性肝病史。治疗17d后患者出现皮肤巩膜黄染、恶心、呕吐、腹胀、纳差。肝功能:ALT828U/L,AST768U/L,TBil222.1μmol/L,DBil100.8μmol/L,TBA283.0μmol/L。入院后患者黄疸持续,TBil最高达273.4μmol/L,PTA45.6%,INR1.63,肝穿刺病理检查提示肝小叶片状坏死,汇管区重度碎屑状坏死及桥接坏死,诊为重症药物性肝炎。停用两种药物,给予保肝和支持治疗,以及血浆置换治疗。入院12周后实验室检查示:ALT49U/L,AST47U/L,TBil52.0μmol/L,DBil44.3μmol/L和TBA37.9μmol/L。出院3个月后肝功能恢复正常。
A 34-year-old woman with chronic pelvic inflammatory disease taking 0.5g Jingangtu capsule 4, 3 times / d; Dan Curcumin ointment 10g, 2 times / d. Past history of patients with no history of drug allergy and chronic liver disease. 17d after treatment, patients with skin scleral yellow dye, nausea, vomiting, bloating, anorexia. Liver function: ALT828U / L, AST768U / L, TBil222.1μmol / L, DBil100.8μmol / L, TBA283.0μmol / L. Patient jaundice persisted after admission, TBil up to 273.4μmol / L, PTA45.6%, INR1.63, liver biopsy prompted lobular necrosis of the hepaticoduode, portal detrusor necrosis and necrosis of the bridge, was diagnosed as severe drug-induced hepatitis. Two drugs were discontinued, hepatoprotective and supportive therapies, and plasmapheresis. After 12 weeks of admission, laboratory tests showed ALT49U / L, AST47U / L, TBil52.0μmol / L, DBil44.3μmol / L and TBA37.9μmol / L. Three months after discharge, liver function returned to normal.