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酮康唑是一种抗霉菌药物,长期口服可引起肝脏损害。但重度黄疸罕见,据估计其发生率为1/15000。本文报告1例如下。女性,59岁,因患甲癣每日服酮康唑200mg已6个月,其间因胃肠道症状而数次中断治疗。患者有进行性厌食、虚弱、关节疼痛等症状,3周后出现黄疸。谷丙转氨酶和谷草转氨酶分别为1475U/L和761 U/L。碱性磷酸酶和血清胆红素分别高达234U/L和7.99 mg/dl。血清学检查无甲型肝炎、乙型肝炎及EB病毒感染。否认应用其它药物、血制品及饮酒。停用酮康唑治疗7周后黄疸及生化指标恢复正常。6个月后患者又因疏忽而服用酮康唑一周,随后再次出现黄疸,并感厌
Ketoconazole is an antifungal drug that causes long-term oral damage to the liver. However, severe jaundice rare, it is estimated that the incidence was 1/15000. This article reports a case as follows. Female, 59 years old, suffering from onychomycosis daily ketoconazole 200mg 6 months, during which several interruptions due to gastrointestinal symptoms. Patients with progressive anorexia, weakness, joint pain and other symptoms, jaundice after 3 weeks. Alanine aminotransferase and aspartate aminotransferase were 1475U / L and 761U / L, respectively. Alkaline phosphatase and serum bilirubin up to 234U / L and 7.99 mg / dl. Serological tests without hepatitis A, hepatitis B and Epstein-Barr virus infection. Denied the use of other drugs, blood products and alcohol. Jaundice and biochemical parameters returned to normal after 7 weeks of ketoconazole treatment was stopped. Six months later, the patient inadvertently took ketoconazole for a week, followed by jaundice and resentment