摘要
目的探讨苯溴马隆致药物性肝损伤的发生规律和特点,为临床安全用药提供参考。方法检索国内外数据库自建库至2017年11月30日所有关于苯溴马隆致药物性肝损伤的个案报道,筛选文献并提取和分析病例资料。结果共检索7篇文献,涉及7例患者。其中,男4例,女3例; 50岁以上6例(85. 71%);以黄种人居多。所有患者均查出肝酶明显升高,多数患者伴有黄疸及恶心、呕吐、腹痛和腹泻等消化道症状;伴发疾病包括糖尿病(2例)、高血压(2例)、高脂血症(1例)等;合用抗痛风药3例,降压药2例,抗甲状腺功能亢进药1例等。均于苯溴马隆治疗1年内出现药物性肝损伤;其中剂量、肝病史与药物性肝损伤的发生关系不大,但剂量加大,患者死亡率增加;经停药及对症治疗,大部分患者均能好转,但仍有3例死亡。结论苯溴马隆致药物性肝损伤较少见,但病情可能很严重甚至会导致死亡。要特别注意患者的年龄、用药剂量、合并症及合并用药等,尤其是男性、50岁以上、治疗1年内、突然出现黄疸或消化道不适、伴发糖尿病、高血压、高脂血症及联用降糖药、抗甲亢药物和别嘌醇,应尽早辨别苯溴马隆所致药物性肝损伤,确保用药安全。
Objective To investigate the occurrence regularity and characteristics of liver injmT induced by benzbromarone, and to provide reference for clinical medieation safety. Methods Case reports of liver injury indueed by benzbromarone were searehed from domestic and foreign databases from inception to November 30, 2017. The literatures were screened as well as the extraction and analysis of case data. Results A total of 7 literatures were retrieved which included 7 cases（4 males and 3 females）. Among them, 6 patients over the age of 50, accounting for 85.71%, and yellow race mostly. All patients were found significantly elevated liver enzymes, most of them were with jaundice, nausea, vomiting, abdominal pain and diarrhea and other gastrointestinal symptoms. In 7 cases, accompanying diseases included 2 cases of diabetes mellitus, 2 cases of hypertension and 1 case of hyperlipidemia. In 7 cases, 3 cases were given combination of anti- gout drugs, 2 cases were given antihypertensive drugs and 1 case was given anti- hyperthyroidism. All 7 patients had drug- induced liver injury within 1 year after treatment with benzbromarone. The dosage and history of liver disease had little to do with drug-induced liver injury. But with the increase of drug dosage, the mortality of patients increased. After withdrawal and symptomatic treatment, most patients improved to discharge, except three patients died. Conclusion Benzbromarone-induced liver injru- is rare, but the condition may be very severe or even lead to death. Special attention should be paid to the age, dosage, complications and combined medication of patients, especially men, over the age of 50, within 1 year of treatment, sudden onset of jaundice or digestive disorders, associated with diabetes, hypertension, hyperlipidemia and combined hypoglycemic drugs, anti-hyperthyroidism drugs and allopurinol, the liver injury induced by benzbromarone should be identified as soon as possible, so as to ensure medication safety.
作者
潘雪芬
艾建国
Pan Xuefen;Ai Jianguo(No.180 Hospital of PLA,Quanzhou,Fujian,China 362000)
出处
《中国药业》
CAS
2018年第23期77-79,共3页
China Pharmaceuticals
关键词
苯溴马隆
药物性肝损伤
药品不良反应
合理用药
文献分析
benzbromarone
drug- induced liver injury
adverse drug reaction
rational drug use
literature review
