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1例22岁男性,因企图自杀口服氨酚伪麻美芬片Ⅱ/氨麻苯美片120片(对乙酰氨基酚总剂量39g),出现恶心呕吐,服药后13h入院。实验室检查:丙氨酸转氨酶(ALT)7385U/L,总胆红素(TBil)26.5μmol/L,直接胆红素(DBil)15.4μmol/L,凝血酶原活动度23.1%;血乳酸3.9mmol/L。诊断为药物性肝衰竭。给予保肝药物,分子吸附再循环和血浆置换治疗。入院第13天患者基本恢复正常,肝功能复查:ALT 146U/L,TBil16.7μmol/L,DBil8.3μmol/L,遂出院。
A 22-year-old man was admitted to hospital at 13 hours after taking the drug because of an attempt to commit suicide orally taking aminophenanthrafenib Ⅱ / aminophenazone 120 tablets (total paracetamol dosage 39g) for nausea and vomiting. Laboratory tests included alanine aminotransferase (ALT) of 7385U / L, total bilirubin (TBil) of 26.5μmol / L, direct bilirubin (DBil) of 15.4μmol / L and prothrombin activity of 23.1% mmol / L. Diagnosis of drug-induced liver failure. Give liver protection drugs, molecular adsorption and plasma exchange therapy. On the 13th day after admission, the patients returned to normal, and the liver function was rechecked: 146U / L ALT, 16.7μmol / L TBil and 8.3μmol / L DBil.