甲巯咪唑致肝损害1例临床分析

摘要

Objective  To investigate the clinical features of liver damage induced by methimazole, clinical safety, provide reference for rational use of methimazole. Methods  A review of the case of methimazole induced drug hepatitis, and carries on the analysis from the aspects of clinical manifestations, mechanism, risk factors, prevention and control measures.Results 71 year old female patient, drug hepatitis in one month after taking methimazole occurred, methimazole dose was 30 mg/d, one month of drug withdrawal and liver protection drugs in the treatment of liver function returned to normal. Conclusion  Methimazole treatment of hyperthyroidism may occur in drug-induced liver injury the use of methimazole should be the drug indication, regular monitoring of liver function, especially at the start of drug treatment for 4 weeks, clinical attention should be paid to monitor liver function, usually after stopping the medicine, liver function returned to normal within 6 weeks. Once the occurrence of liver injury should be timely reduction or withdrawal, and take corresponding measures to avoid treatment, drug combination, and pay attention to the dosage and course of treatment etc.%目的：探讨甲巯咪唑致肝损害的临床特点，为临床安全、合理使用甲巯咪唑提供参考。方法对甲巯咪唑致药物性肝炎病例进行回顾，并从临床表现、作用机制、危险因素、防治措施等方面进行分析。结果71岁女性患者，药物性肝炎在服用甲巯咪唑后的1个月后发生，甲巯咪唑的剂量为30mg/d，停药1个月以及保肝药物治疗后肝功能恢复正常。结论甲巯咪唑治疗甲亢可能发生药物性肝损害故使用甲巯咪唑时应有用药指征，定期监测肝功能，尤其是在开始药物治疗的4周内，临床应注意监测肝功能，通常停药后6周内肝功能恢复正常。一旦发生肝损害应及时减量或停药，并采取相应治疗措施，避免联合用药，并注意剂量和疗程等。