胺碘酮注射液致急性肝衰竭1例A case report of acute liver failure induced by amiodarone injection
杨欣;袁世加;周杭;方庆;周磊;喻倩;邓连力;冉莎莎;
摘要(Abstract)：
报道1例胺碘酮注射液致急性肝衰竭的病例。患者为老年男性,因急性心肌梗死(非ST段抬高型)入院治疗。住院期间因频发室上性心动过速而加胺碘酮注射液治疗(首剂150 mg,缓慢iv;之后在15 h内持续静脉泵入750 mg),1 d后出现肝功能衰竭(ALT1 509 U·L(-1),AST 2 556 U·L(-1),AST 2 556 U·L(-1))。经停用胺碘酮注射液并予保肝治疗,5 d后肝功能逐渐恢复。采用RUCAM因果关系评估量表,得分为7分,急性肝功能衰竭与胺碘酮注射液之间相关性为极可能。
关键词(KeyWords)： 胺碘酮;急性肝衰竭;RUCAM因果关系评估量表;肝细胞损伤型;保肝药
基金项目(Foundation):
作者(Authors): 杨欣;袁世加;周杭;方庆;周磊;喻倩;邓连力;冉莎莎;
DOI: 10.19577/j.1007-4406.2022.01.014
参考文献(References)：
- [1]于无嫌.胺碘酮治疗心力衰竭合并心律失常的不良反应[C]//《临床心身疾病杂志》2015年12月研讨会综合刊.2015:263.
- [2]蔡珊,苏丽军,王建中.静脉注射胺碘酮引起进行肝损害临床分析[J].中国实用医药,2012,7(28):176.
- [3]RICHER M,ROBERT S.Fatal hepatotoxicity following oral administration of amiodarone[J].Ann Pharmacother,1995,29(6):582.
- [4]SPANIOL M,BRACHER R,HA H R,et al.Toxicity of amiodarone and amiodarone analogues on isolated rat liver mitochondria[J].J Hepatol,2001,35(5):628.
- [5]HOSTETLER K Y,REASOR M J,WALKER E R,et al.Role of phospholipase A inhibition in amiodarone pulmonary toxicity in rats[J].Biochim Biophys Acta,1986,875(2):400.
- [6]TAKAI S,ODA S,TSUNEYAMA K,et al.Establishment of a mouse model for amiodarone-induced liver injury and analyses of its hepatotoxic mechanism[J].J Appl Toxicol,2016,36(1):35.
- [7]MUDALEL M L,DAVE K P,HUMMEL J P,et al.N-acetylcysteine treats intravenous amiodarone induced liver injury[J].World JGastroenterol,2015,21(9):2816.
- [8]BRIEN J F,JIMMO S,BRENNAN F J,et al.Distribution of amiodarone and its metabolite,desethylamiodarone,in human tissues[J].Can J Physiol Pharmacol,1987,65(3):360.
- [9]陈秋琴,王君萍.阿托伐他汀联合胺碘酮致肝药酶升高2例分析[J].中国药房,2011,22(28):2639.
- [10]RHODES A,EASTWOOD J B,SMITH S A.Early acute hepatitis with parenteral amiodarone:a toxic effect of the vehicle?[J].Gut,1993,34(4):565.
- [11]MUNOZ A,KARILA P,GALLAY P,e t a l.A randomized hemodynamic comparison of intravenous amiodarone with and without Tween 80[J].Eur Heart J,1988,9(2):142.
- [12]VAN TELLINGEN O,BEIJNEN J H,VERWEIJ J,et al.Rapid esterase-sensitive breakdown of polysorbate 80 and its impact on the plasma pharmacokinetics of docetaxel and metabolites in mice[J].Clin Cancer Res,1999,5(10):2918.
- [13]ESSRANI R,MEHERSHAHI S,ESSRANI R,et al.2383amiodarone-induced acute liver injury[J].Am J Gastroenterol,2019,114(1):S1324.
- [14]MOHAMED M,A L-H I L L A N A,F L O R E S M,e t a l.Concomitant acute hepatic failure and renal failure induced by intravenous amiodarone:a case report and literature review[J].Gastroenterology Res,2020,13(1):40.
- [15]田德安,谢渭芬,等.药物性肝损伤基层诊疗指南(2019年)[J].中华全科医师杂志,2020,19(10):868.
- [16]WALDHAUSER K M,TOROK M,HA H R,et al.Hepatocellular toxicity and pharmacological effect of amiodarone and amiodarone derivatives[J].J Pharmacol Exp Ther,2006,319(3):1413.
- [17]YE J H,HO Y F,ON A W F,et al.Trends in reporting drugassociated liver injuries in Taiwan:a focus on amiodarone[J].Int J Clin Pharm,2018,40(4):911.
- [18]NASSER M,LARSEN T R,WAANBAH B,et al.Hyperacute druginduced hepatitis with intravenous amiodarone:case report and review of the literature[J].Drug Healthc Patient Saf,2013,5:191.
- [19]郭继鸿.胺碘酮的现代观点(续)[J].临床心电学杂志,2007,16(3):215.
- [20]EPSTEIN A E,OLSHANSKY B,NACCARELLI G V,et al.Practical management guide for clinicians who treat patients with amiodarone[J].Am J Med,2016,129(5):468.