摘要
1例47岁女性患者行冠状动脉支架术后给予氟伐他汀40mg,每晚1次,并同时给予阿司匹林、氯吡格雷、美托洛尔、单硝酸异山梨酯联合治疗。2个月后患者出现乏力、消瘦、纳差、恶心,伴随皮肤黄染、尿色加深。血生化检查:ALT777U/L,AST903U/L,ALP367U/L,γ-GT678U/L,TBil158.78μmol/L,DBil123.86μmol/L,IBil34.92μmol/L,TBA139.7μmol/L。自身抗体检查:抗核抗体及抗干燥综合征A抗原抗体阳性。停用氟伐他汀,继续服用阿司匹林、氯吡格雷、美托洛尔、单硝酸异山梨酯,并给予复方甘草酸苷、还原型谷胱甘肽及熊去氧胆酸等治疗。随后患者肝功能逐渐好转,1个月后血生化检查:ALT29U/L,AST33U/L,ALP122U/L,γ-GT150U/L,TBil40.04μmol/L,DBil26.84μmol/L,IBil13.20μmol/L,TBA25μmol/L,遂出院。出院后1个月复查肝功能恢复正常。
A 47-year-old woman received fluvastatin 40 mg per night after coronary stenting.Meanwhile she was given aspirin,clopidogrel,metoprolol and isosorbide mononitrate.Two months later,the patient presented with asthemia,emaciation,anorexia,and nausea with yellowish skin and dark urine.Biochemical tests showed the following levels：ALT 777 U/L,AST 903 U/L,ALP 367U/L,γ-GT 678U/L,TBil 158.78 μmol/L,DBil 123.86 μmol/L,IBil 34.92 μmol/L,TBA 139.7 μmol/L.Autoantibody tests were positive for antinuclear antibody and anti-SSA antibody.Fluvastatin was withdrawn and aspirin,clopidogrel,metoprolol and isosorbide mononitrate were continued.She was treated with compound glycyrrhizin,reduced glutathione,and ursodeoxycholic acid as well.Subsequently,her liver function improved gradually.One month later,biochemical tests revealed the following values：ALT 29 U/L,AST 33 U/L,ALP 122 U/L,γ-GT 150 U/L,TBil 40.04 μmol/L,DBil 26.84 μmol/L,IBil 13.20 μmol/L,TBA 25 μmol/L.Then the patient was discharged.Her liver function normalized on reexamination a month after discharge.
出处
《药物不良反应杂志》
2010年第5期366-368,共3页
Adverse Drug Reactions Journal
关键词
氟伐他汀
不良反应
肝损害
fluvastatin
adverse reactions
liver injury
