Eszopiclone aggravates liver injury caused by trazodone hepatotoxicity: A case report
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摘要:
<正>1病例资料患者女性,53岁,因"发现乙型肝炎病原学阳性36年,腹胀、乏力1年,加重伴纳差7 d",于2019年11月12日入本院。患者36年前体检发现乙型肝炎病原学阳性,未诊治。2018年8月患者出现腹胀、乏力,肝酶学正常,HBV DNA 1.81×106IU/ml,肝脏瞬时弹性成像5.2 kP a,未规范治疗,后规律复查肝功能均未见异常。7 d前患者腹胀、乏力症状加重,伴有纳差,肝功能酶学指标明显升高。既往:有乙型肝炎家族史,母亲为HBV携带者,2001年出现"焦虑、恐惧、寐差",确诊为"神经官能症",
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关键词:
- 化学性与药物性肝损伤 /
- 曲唑酮 /
- 右佐匹克隆 /
- 细胞色素P-450 CYP3A
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Key words:
- chemical and drug induced liver injury /
- trazodone /
- eszopiclone /
- cytochrome P-450 CYP3A
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[1] ZHANG QR,WANG W,ZHENG XX. Efficacy of venlafaxine combined with eszopiclone in the treatment of generalized pyrogenic disorder with insomnia[J]. Chin Foreign Med Res,2020,18(2):1-3.(in Chinese)张清如,王巍,郑小星.文拉法辛联合右佐匹克隆治疗广泛性焦障虑碍伴失眠症状效果研究[J].中外医学研究,2020,18(2):1-3. [2] CHALASANI NP,HAYASHI PH,BONKOVSKY HL,et al. ACG clinical guideline:The diagnosis and management of idiosyncratic drug-induced liver injury[J]. Am J Gastroenterol,2014,109(7):950-966. [3] Drug-induced Liver Disease Study Group,Chinese Society of Hepatology,Chinese Medical Association. Guidelines for the management of drug-induced liver injury[J]. J Clin Hepatol,2015,31(11):1752-1769.(in Chinese)中华医学会肝病学分会药物性肝病学组.药物性肝损伤诊治指南[J].临床肝胆病杂志,2015,31(11):1752-1769. [4] ROBLES-DIAZ M,LUCENA MI,KAPLOWITZ N,et al. Use of Hy's law and a new composite algorithm to predict acute liver failure in patients with drug-induced liver injury[J]. Gastroenterology,2014,147(1):109-118. e5. [5] YU YC,FAN Y,CHEN CW. Diagnosis and treatment of druginduced liver injury[J]. J Clin Hepatol,2018,34(6):1160-1165.(in Chinese)于乐成,范晔,陈成伟.药物性肝损伤的诊断和治疗[J].临床肝胆病杂志,2018,34(6):1160-1165. [6] WANG QH,FU XF,GUO YN,et al. Medication situation and charactefisfics of patients with drug-induced liver injury[J].Lab Med Clin,2019,16(24):3623-3626.(in Chinese)王全华,付辛芳,虢艳宁,等.药物性肝损伤患者用药情况及临床特征分析[J].检验医学与临床,2019,16(24):3623-3626. [7] FERNANDES NF,MARTIN RR,SCHENKER S. Trazodone-induced hepatotoxicity:A case report with comments on druginduced hepatotoxicity[J]. Am J Gastroenterol,2000,95(2):532-535. [8] CARVALHANA S,OLIVEIRA A,FERREIRA P,et al. Acute liver failure due to trazodone and diazepam[J]. GE Port J Gastroenterol,2017,24(1):40-42. [9] NAJIBI A,HEIDARI R,ZARIFI J,et al. Evaluating the role of drug metabolism and reactive intermediates in trazodone-induced cytotoxicity toward freshly-isolated rat hepatocytes[J]. Drug Res(Stuttg),2016,66(11):592-596. [10] KALGUTKAR AS,HENNE KR,LAME ME,et al. Metabolic activation of the nontricyclic antidepressant trazodone to electrophilic quinone-imine and epoxide intermediates in human liver microsomes and recombinant P4503A4[J]. Chem Biol Interact,2005,155(1-2):10-20. [11] ZALMA A,von MOLTKE LL,GRANDA BW,et al. In vitro metabolism of trazodone by CYP3A:Inhibition by ketoconazole and human immunodeficiency viral protease inhibitors[J]. Biol Psychiatry,2000,47(7):655-661. [12] KALGUTKAR AS,HENNE KR,LAME ME,et al. Metabolic activation of the nontricyclic antidepressant trazodone to electrophilic quinone-imine and epoxide intermediates in human liver microsomes and recombinant P4503A4[J]. Chem-Biol Interact,2005,155(1-2):10-20. [13] JADWIGA N. Eszopiclone,a nonbenzodiazepine sedativehypnotic agent for the treatment of transient and chronic insomnia[J]. Clin Ther,2006,28(4):491-516. [14] LI S,HU ZH,MIAO XH. Effects of chronic HBV infection on human hepatic cytochrome P450 3A4[J]. Natl Med J China,2006,86(38):2703-2706.(in Chinese)李爽,胡卓汉,缪晓辉.慢性乙型肝炎病毒感染对人肝细胞色素酶P450 3A4的影响[J].中华医学杂志,2006,86(38):2703-2706. [15] LI YZ,ZHANG ZH,LI X. Cytochrome P450 2C9 and 3A4gene polymorphisms and its functional significances[J]. Inter J Epidemiol Infect Dis,2011,38(4):261-264.(in Chinese)李筠竹,张振华,李旭.细胞色素P450同工酶2C9和3A4基因多态性及其功能意义[J].国际流行病学传染病学杂志,2011,38(4):261-264.
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