摘要
1例56岁男性患者,因剧烈咳嗽咳痰3 d入院。既往矽肺病史2年余,入院诊断考虑矽肺伴感染,经验性给予注射用头孢他啶(2 g,q 8 h,ivgtt)抗感染治疗。用药5 d后,肝功能检查示:丙氨酸氨基转移酶(ALT)293 U·L^(-1),天门冬氨酸氨基转移酶(AST)61 U·L^(-1),谷氨酰胺转移酶(GGT)280 U·L^(-1),碱性磷酸酶(ALP)140 U·L^(-1)。患者既往无肝脏疾病,入院时肝功能指标正常,排除病毒性肝炎和自身免疫性肝炎等病因,考虑头孢他啶引起的肝损伤可能性大。立即停用注射用头孢他啶,改为注射用头孢地嗪,并给予注射用还原型谷胱甘肽、复方甘草酸苷注射液和水飞蓟宾胶囊等进行保肝、降酶治疗。5 d后患者肝功能指标明显改善,准予出院,并继续口服护肝药物序贯治疗。2周后门诊随访,患者肝功能已基本恢复正常。
A 56-year-old male patient with a medical history of 2 years silicosis disease was hospitalized due to continuous severe cough with phlegm for 3 days.He was diagnosed as silicosis with infection and was empirically given ceftazidime(2 g,q 8 h,ivgtt)after admission.5 days later,results of laboratory test were as follows:alanine aminotransferase(ALT)293 U·L^(-1),aspartate aminotransferase(AST)61 U·L^(-1),glutamyltranspeptidase(GGT)280 U·L^(-1),and alkaline phosphatase(ALP)140 U·L^(-1).He had no previous history of liver disease and the laboratory results of liver function were normal at admission.Liver injury induced by ceftazidime was considered after excluding other etiology including viral hepatitis and autoimmune hepatitis.Ceftazidime was immediately discontinued and replaced by cefodizime.And symptomatic treatment including reduced glutathione,compound glycyrrhizin injection and silymarin capsules were given to him.5 days later,his liver function was significantly improved and was discharged with oral hepatic-protective drugs.Follow-up visit 2 weeks later in clinic showed that his liver function return to normal.
作者
蔡杰
韩陈媛
江君微
CAI Jie;HAN Chen-yuan;JIANG Jun-wei(Department of Pharmacy,Wenling Hospital of Traditional Chinese Medicine,Wenling 317500,China)
出处
《中国药物应用与监测》
CAS
2021年第2期140-142,共3页
Chinese Journal of Drug Application and Monitoring
关键词
头孢他啶
药物性肝损伤
药品不良反应
Ceftazidime
Drug-induced liver injury
Adverse drug reaction
