CAJ | 학술논문

1例75岁女性患者因高血压病和心房颤动遵国外医院医嘱口服美托洛尔(100 mg/早,75 mg/晚)及利伐沙班(20 mg/晚).1个月后肝功能检查示丙氨酸转氨酶(ALT) 90 U/L、γ-谷氨酰转肽酶(γ-GT)133 U/L,且出现视物模糊.停用利伐沙班,次日患者视物模糊症状消失,第3天ALT49 U/L,γ-GT 73 U/L.停用利伐沙班第2天给予华法林(3.0 mg/晚)口服.次日患者出现血尿,急查INR为0.98.患者拒绝继续使用华法林,遂重新减量口服利伐沙班(10 mg/晚,药物自备),并严密监测肝功能和眼部症状.此后ALT及γ-GT水平均基本正常,视物模糊症状未再出现.
1례75세녀성환자인고혈압병화심방전동준국외의원의촉구복미탁락이(100 mg/조,75 mg/만)급리벌사반(20 mg/만).1개월후간공능검사시병안산전안매(ALT) 90 U/L、γ-곡안선전태매(γ-GT)133 U/L,차출현시물모호.정용리벌사반,차일환자시물모호증상소실,제3천ALT49 U/L,γ-GT 73 U/L.정용리벌사반제2천급여화법림(3.0 mg/만)구복.차일환자출현혈뇨,급사INR위0.98.환자거절계속사용화법림,수중신감량구복리벌사반(10 mg/만,약물자비),병엄밀감측간공능화안부증상.차후ALT급γ-GT수평균기본정상,시물모호증상미재출현.
A 75-year-old female patient received oral metoprolol (100 mg every morning and 75 mg every night) and rivaroxaban (20 mg every night) for hypertension and atrial fibrillation following the advice of doctor in hospital.One month later,liver function tests showed an alanine aminotransferase(ALT) value of 90 U/L and gamma-glutamyl transpeptidase(γ-GT) value of 133 U/L and the patient developed blurred vision.Rivaroxaban was stopped and,on the next day,her blurred vision disappeared.On day 3,the levels of ALT and γ-GT were 49 U/L and 73 U/L,respectively.On the second day after stopping rivaroxaban,oral warfarin 3 mg every night was given.The next day,the patient presented with hematuria and an emergency test showed an INR level of 0.98.The patient refused to continue using warfarin.Then she took reduced-dose rivaroxaban (10 mg every night and providing for herself) again and the liver function and ocular symptoms were monitored closely.Henceforth,the levels of ALT and γ-GT were normal basically and blurred vision did not recur.