摘要
本文报道1例66岁男性患者,因急性左心衰竭、低钠血症入院。入院第1天给予托伐普坦片15 mg口服,第2天患者转氨酶明显升高,丙氨酸转氨酶916.76 U·L^(-1),天冬氨酸转氨酶1 857.1 U·L^(-1),符合严重急性肝功能损伤的诊断标准。立即停药并给予保肝治疗,入院第10天,患者肝功能明显好转,入院第12天,患者病情稳定后出院。关联性评价结果显示,该患者急性肝损伤的发生与托伐普坦很可能有关。本文对托伐普坦引起肝功能损伤的发生机制、发生时间、发生人群和治疗进行探讨,提示临床使用托伐普坦时应高度警惕肝损伤,常规监测患者肝功能,以确保安全用药。
A 66-year-old man was admitted with acute left heart failure and hyponatremia.On the first day of admission,15 mg tolvaptan tablets were given orally.On the second day of admission,alanine transaminase and aspartate transaminase were significantly increased to 916.76 U·L^(-1) and 1857.1 U·L^(-1),respectively,which met the diagnostic criteria of severe acute liver injury.The drug was immediately stopped and hepatoprotective therapy was given,and on the 10th day of admission,the patient's liver function improved significantly,and on the 12th day of admission,the patient was discharged after his condition stabilised.The results of the correlation evaluation indicated that the development of acute liver injury in this patient is likely related to tolvaptan.This article discusses the mechanism,time of occurrence,population and treatment of tolvaptan-induced liver function injury,suggesting that clinical use of tolvaptan should be highly vigilant for acute liver function injury and routine monitoring of patients'liver function to ensure the safe use of the drug.
作者
王柯欣
石二霞
周忠艳
何轩
WANG Kexin;SHI Erxia;ZHOU Zhongyan;HE Xuan(Department of Pharmacy,The First Hospital of Huhhot,Hohhot 010030,China)
出处
《药物流行病学杂志》
2025年第7期830-834,共5页
Chinese Journal of Pharmacoepidemiology
基金
内蒙古医学科学院公立医科研联合基金项目(2024GLLH0422)
呼和浩特市基础研究与应用基础研究项目(2024-规-基-4)。
关键词
托伐普坦片
急性肝功能损伤
药品不良反应
Tolvaptan tablets
Acute liver function injury
Adverse drug reactions
