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应用水杨酸盐和扑热息痛造成的肝损害已引起人们的注意。目前已报告300例由于水杨酸盐治疗出现转氨酶升高或肝损伤者,其中60%为风湿性关节炎病人。综述一组长期应用水杨酸盐引起肝障碍的病例表明,4%为严重的进行性肝疾病和致命性肝坏死,肝的形态学特征为肝细胞损伤,表现为病灶坏死、细胞肿胀、细胞内外有嗜酸体;少数出现黄疸或凝血时间异常;70%的病例转氨酶超过500单位;30%出现脑脊髓病。显然,长期应用水杨酸盐的病人,应仔细进行临床和实验室监测,尤其是分析转氨酶活性和血清水杨酸盐浓度,有症状或其它异常(尤其是凝血时间)时应立即停药。治疗剂量或近似治疗剂量扑热息痛也有引起肝损害的报告。分析18例病人,其中9例摄入近似超剂量的扑热息痛(嗜酒者7例);余9例中6例为嗜酒者,
Liver damage caused by the use of salicylates and paracetamol has attracted the attention of people. Has been reported in 300 cases of salicylate due to elevated aminotransferases or liver damage, of which 60% of rheumatoid arthritis patients. Summary of a series of long-term application of salicylate-induced liver disorders in patients showed that 4% of severe progressive liver disease and fatal liver necrosis, liver morphological characteristics of liver cell damage, manifested as focal necrosis, cell swelling, cells There are eosinophils inside and outside; a small number of jaundice or abnormal clotting time; 70% of the cases more than 500 units aminotransferase; 30% of brain myelopathy. Obviously, long-term use of salicylate patients, careful clinical and laboratory monitoring, especially the analysis of aminotransferase activity and serum salicylate concentration, symptoms or other abnormalities (especially clotting time) should be discontinued immediately. Paracetamol is also reported as a cause of liver damage at or near the same therapeutic dose. Eighteen patients were analyzed, 9 of whom ingested approximately an overdose of paracetamol (7 alcoholics); 6 of the remaining 9 were alcoholics,