摘要
目的分析左甲状腺素钠引起患者肝损伤不良反应(ADR)的特点,为临床合理用药提供参考。方法检索PubMed、Embase、Cochrane Library、中文学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库(WanFang Data)、维普中文期刊全文数据库(VIP)等关于左甲状腺素致患者肝损伤的报道,从患者的基本状况、原发疾病、服用剂量、肝损出现时间、肝损类型和伴随症状、对策和预后等方面进行分析。结果共收集到文献11篇,其中国内报道2篇、国外报道9篇;共涉及患者11例,其中男性2例、女性9例,50~70岁患者占比较高(占54.55%);除1例因先天垂体发育不全外,其余原发疾病为不同原因引起的甲状腺功能减退;起始剂量多为25、50μg/d(占72.73%),近半数患者(占45.46%)用药过程中增加剂量;多数患者(占54.55%)肝损伤发生在用药7~60 d;肝损伤类型中肝细胞损伤型、混合型、胆汁淤积型分别占36.37%、27.28%、18.19%,患者多伴有发热、疲劳、厌食等症状;多数患者(占90.91%)在肝损伤发生后更换药品,换药后肝功能恢复正常。结论使用左甲状腺素钠时应加强用药监测,减少肝损伤ADR的发生。
Objectives To analyze the characteristics of liver injury adverse reactions(ADRs)caused by levothyroxine in patients,and to provide reference for rational clinical use.Methods Cases of liver injury caused by levothyroxine in patients were retrieved from PubMed,Embase,Cochrane Library,CNKI,CBM,WanFang Data,VIP and analyzed from the aspects of patients'basic condition,primary disease,dosage,time of liver injury,type and associated symptoms,countermeasures and prognosis.Results A total of 11 qualified documents were analyzed,including two domestic cases and nine foreign cases.A total of 11 patients were involved,including two males and nine females.The proportion of patients aged 50—70 years was relatively high(54.55%).Except for 1 case of congenital pituitary dysplasia,the primary diseases of other cases were hypothyroidism caused by different causes.Most of the initial dose was 25 or 50μg/d(72.73%),and the dose of nearly half of the patients(45.46%)was increased.Most of the patients(54.55%)suffered liver damage within 7 to 60 days of administration.Among the liver lesion types,the liver cell injury type,the mixed type and the cholestasis type accounted for 36.37%,27.28%and 18.19%respectively.Drugs of most of the patients(90.91%)were changed after liver damage,and the liver function returned to normal after dressing change.Conclusion When levothyroxine are used by patients,medication monitoring should be strengthened to reduce the occurrence of adverse reactions caused by liver damage.
作者
李玉柳
吕萌
张淼
LI Yuliu;LÜ Meng;ZHANG Miao(Children's Hospital Affiliated to Zhengzhou University,Henan Children's Hospital,Zhengzhou Children's Hospital,Zhengzhou 450018,China)
出处
《药物评价研究》
CAS
2021年第7期1508-1512,共5页
Drug Evaluation Research
基金
中国药学会全国医药经济信息网科技传播创新工程[CMEI2021KPYJ(JZX)00104]
河南省医学科技攻关计划项目(2018020663)。
关键词
左甲状腺素钠
肝损伤
药物不良反应
合理用药
文献分析
levothyroxine sodium
liver injury
drug adverse reactions
rational clinical use
literature analysis
