复方氨林巴比妥注射液致肝损伤

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1例34岁女性患者因急性上呼吸道感染伴高热,给予复方氨林巴比妥注射液肌内注射。用药后8 h出现深黄色尿,随之出现乏力、纳差和皮肤黄染。实验室检查示丙氨酸转氨酶(ALT)764 U/L,天冬氨酸转氨酶(AST)211 U/L,碱性磷酸酶(ALP)280 U/L,γ-谷氨酰转酶(γ-GT)861 U/L,总胆红素(TBil)72.0 μmol/L,直接胆红素(DBil)61.3 μmol/L,间接胆红素(IBil)10.7 μmol/L。诊断:药物性肝损伤,可能与复方氨林巴比妥有关。立即给予保肝药物治疗。16 d后,患者黄疸消退,实验室检查示ALT 58 U/L,AST 34 U/L,ALP 237 U/L,γ-GT 345 U/L,TBil 26.0 μmol/L,DBil 13.1 μmol/L。“,”A 34-year-old female patient received an intramuscular injection of compound amionpyrine antipyrine barbitone injection for acute upper respiratory infection and fever. Eight hours after medication, the patient developed deep yellow urine followed by fatigue, anorexia, and yellowish skin. Laboratory tests showed alanine aminotransferase (ALT) 764 U/L, aspartate aminotransferase (AST) 211 U/L, alkaline phosphatase (ALP) 280 U/L, gamma-glutamyltransferase (γ-GT) 861 U/L, total bilirubin (TBil) 72.0 μmol/L, direct bilirubin (DBil) 61.3 μmol/L, and indirect bilirubin (IBil)10.7 μmol/L. The patient was diagnosed as having drug-induced liver injury, which might be related to compound amionpyrine antipyrine barbitone injection. Therapy with liver-protective drugs was given immediately. Sixteen days later, her jaundice subsided. The laboratory tests showed ALT 58 U/L, AST 34 U/L, ALP 237 U/L, γ-GT 345 U/L, TBil 26.0 μmol/L, and DBil 13.1 μmol/L.
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