药物不良反应杂志
藥物不良反應雜誌
약물불량반응잡지
ADVERSE DRUG REACTIONS JOURNAL
2013年
5期
286-287
,共2页
尼美舒利%成人斯蒂尔病%药物性肝损害%肾损害
尼美舒利%成人斯蒂爾病%藥物性肝損害%腎損害
니미서리%성인사체이병%약물성간손해%신손해
Nimesulide%Adult-onset Still's disease%Drug-induced liver injury%Renal injury
1例22岁初诊成人斯蒂尔病女性患者经甲泼尼龙抗炎以及护肝、护胃等治疗1周,关节痛及体温控制不理想,遂加用尼美舒利100 mg口服,2次/d.用该药前天冬氨酸转氨酶(AST)60 U/L,丙氨酸转氨酶(ALT)50 U/L,肾功能正常.9d后复查,AST 458 U/L,ALT 450 U/L,怀疑为尼美舒利引起的药物性肝损害,故停用该药并加强护肝治疗.11d后复查,AST 221 U/L,ALT 97 U/L.因病情需要,再次给予尼美舒利100 mg口服,2次/d.再次用药的第4天晨患者出现排尿困难,血清尿素11.2 mmol/L,肌酐109 μmol/L,尿酸435 μmol/L;第5天AST 542 U/L,ALT 104 U/L.考虑为尼美舒利引起的肝肾功能损害,停用该药.4d后患者肾功能指标恢复正常;2周后AST 47 U/L,ALT32 U/L.
1例22歲初診成人斯蒂爾病女性患者經甲潑尼龍抗炎以及護肝、護胃等治療1週,關節痛及體溫控製不理想,遂加用尼美舒利100 mg口服,2次/d.用該藥前天鼕氨痠轉氨酶(AST)60 U/L,丙氨痠轉氨酶(ALT)50 U/L,腎功能正常.9d後複查,AST 458 U/L,ALT 450 U/L,懷疑為尼美舒利引起的藥物性肝損害,故停用該藥併加彊護肝治療.11d後複查,AST 221 U/L,ALT 97 U/L.因病情需要,再次給予尼美舒利100 mg口服,2次/d.再次用藥的第4天晨患者齣現排尿睏難,血清尿素11.2 mmol/L,肌酐109 μmol/L,尿痠435 μmol/L;第5天AST 542 U/L,ALT 104 U/L.攷慮為尼美舒利引起的肝腎功能損害,停用該藥.4d後患者腎功能指標恢複正常;2週後AST 47 U/L,ALT32 U/L.
1례22세초진성인사체이병녀성환자경갑발니룡항염이급호간、호위등치료1주,관절통급체온공제불이상,수가용니미서리100 mg구복,2차/d.용해약전천동안산전안매(AST)60 U/L,병안산전안매(ALT)50 U/L,신공능정상.9d후복사,AST 458 U/L,ALT 450 U/L,부의위니미서리인기적약물성간손해,고정용해약병가강호간치료.11d후복사,AST 221 U/L,ALT 97 U/L.인병정수요,재차급여니미서리100 mg구복,2차/d.재차용약적제4천신환자출현배뇨곤난,혈청뇨소11.2 mmol/L,기항109 μmol/L,뇨산435 μmol/L;제5천AST 542 U/L,ALT 104 U/L.고필위니미서리인기적간신공능손해,정용해약.4d후환자신공능지표회복정상;2주후AST 47 U/L,ALT32 U/L.
A 22-year-old female patient who was newly diagnosed with adult-onset Still's disease received an oral nimesulide 100 mg twice daily because her arthralgia and fever were not improved after one week of treatments with anti-inflammatory drug methylprednisolone as well as liver and stomach-protective treatments.Before the nimesulide administration,the patient's aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were 60 U/L and 50 U/L,respectively and her renal function was normal.After 9 days of nimesulide treatment,her AST and ALT levels were 458 U/L and 450 U/L,respectively.Drug-induced liver injury associated with nimesulide was suspected.Nimesulide was stopped and liver-protective treatments were given.Eleven days later,her AST and ALT levels were 221 U/L and 97 U/L,respectively.Because of the patient's condition,nimesulide was givcn again.On the 4th day,she developed dysuria and her levels of serum urea nitrogen,serum creatinine,and uric acid were 11.2 mmol/L,109 μmol/L,and 435 μmol/L,respectively.On the 5th day of administration,her AST and ALT levels were 542 U/L and 104 U/L,respectively.Drug-induced liver injury as well as renal injury associated with nimesulide was considered.Nimesulide was stopped.Four days later,her renal function returned to normal and 2 weeks later,her AST and ALT levels returned to 47 U/L and 32 U/L,respectively.