Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb.
Drug-Induced Liver Injury: Twenty Five Cases of Acute Hepatitis Following Ingestion of Polygonum multiflorum Thunb.
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DOI：
10.5009/gnl.2011.5.4.493
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发表时间：
2011-12
期刊：
影响因子：
3.4
通讯作者：
Shim SG
中科院分区：
文献类型：
--
作者：
Jung KA;Min HJ;Yoo SS;Kim HJ;Choi SN;Ha CY;Kim HJ;Kim TH;Jung WT;Lee OJ;Lee JS;Shim SG
补充药物，包括草药制剂和营养补充剂，无需处方即可广泛使用。因此，人们对这些药物的肝毒性风险越来越感兴趣。很难确定这些草药制剂与肝毒性之间的因果关系。我们报告了 25 名因摄入何首乌而诊断为中毒性肝炎的患者。 2007年至2009年间，我院收治了25例疑似何首乌引起的肝损伤患者（中位年龄48岁[24至65岁]；男：女=18：7）。我们分析了临床和组织学数据，包括何首乌摄入类型、持续时间以及住院治疗时间。我们还使用 R 比值（血清 ALT 活性/血清 ALP 活性）确定肝损伤的类型。使用的辅助药物种类包括茶（n=16）、酒（n=5）、茶和酒（n=2）、粉末（n=1）和蜜布丁（n=1）。最常见的症状是黄疸 (76%)，18 名患者 (72%) 有肝细胞性肝损伤的证据。在所有进行肝活检的病例（n=10）中，组织学结果与急性肝炎一致。 23名患者（91.6%）经保守治疗康复，1名患者（4%）接受肝移植，1名患者（4%）死于肝功能衰竭。在我们的案例中，我们发现何首乌可能具有肝毒性，可能导致严重的药物性肝损伤，甚至死亡。
Complementary medicines, including herbal preparations and nutritional supplements, are widely used without prescriptions. As a result, there has been growing interest in the risk of hepatotoxicity with these agents. It is difficult to determine causal relationships between these herbal preparations and hepatotoxicity. We report on 25 patients diagnosed with toxic hepatitis following ingestion of Polygonum multiflorum Thunb. Twenty-five patients (median age, 48 years [24 to 65 years]; M:F=18:7) with suspected P. multiflorum Thunb-induced liver injury were admitted to our hospital between 2007 and 2009. We analyzed clinical and histological data, including the types and the duration of P. multiflorum Thunb intake and the duration of hospital care. We also determined the type of liver injury using the R ratio (serum activity of ALT/serum activity of ALP). The types of complementary medicine used included tea (n=16), liquor (n=5), tea and liquor (n=2), powder (n=1), and honeyed pudding (n=1). The most common presenting sign was jaundice (76%), and 18 patients (72%) had evidence of hepatocellular liver injury. Histological findings were consistent with acute hepatitis in all cases (n=10) for which liver biopsy was performed. Twenty-three patients (91.6%) recovered with conservative management, 1 patient (4%) had a liver transplant, and 1 patient (4%) died of hepatic failure. In our cases, we found that P. multiflorum Thunb could be hepatotoxic and could lead to severe drug-induced liver injury, and even death.
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