西地那非致药物性肝损伤的文献分析
Analysis of liver injury induced by sildenafil
曹小雨 1葛洁 2王婧雯 2杨瑞霞 1王莹3
作者信息
- 1. 西安医学院第二附属学院临床药学科,西安 710038
- 2. 空军军医大学第一附属医院药剂科,西安 710032
- 3. 三原县人民医院药剂科,咸阳 713800
- 折叠
摘要
目的:通过分析西地那非致药物性肝损伤(DILI)的病例报道,探讨DILI的特点,为西地那非导致DILI的不良反应提供依据.方法:检索国内外西地那非导致DILI的病例报道,对病例中患者的药物治疗、DILI情况、治疗措施及转归等进行分析,比较国内外西地那非导致DILI处理措施的异同并探讨西地那非致DILI的作用机制.结果:本文共检索到国内外相关报道6例;6例均为男性,服用西地那非剂量为25～100 mg;6例服用西地那非致DILI的时间差异较大;4例临床症状表现为皮肤黄染,肝内成胆汁淤积;3例受损类型为胆汁淤积型;3例DILI极可能由西地那非导致,3例很可能由西地那非导致;4例为重度肝损伤;2例为轻度肝损伤;6例停用西地那非后,肝功能均可逐渐恢复或正常.结论:西地那非导致DILI鲜有报道,作用机制尚不完全明确,可能与其改变肝脏组织有关,建议长期或较大剂量服用西地那非的患者注意监测肝功能.
Abstract
Objective:To analyze the reports of drug-induced liver injury(DILI)induced by sildenafil,explore the characteristics of DILI,and provide evidence for the liver damage of sildenafil.Methods:The relevant literature at home and abroad were reviewed.Medications,DILI,treatments and outcomes of the patients were analyzed.The difference between home and abroad in treatments of DILI was compared.The mechanisms of sildenafil-induced DILI were studied.Results:A total of 6 cases were reported and all patients were male.The dosage of sildenafil was 25 mg to 100 mg.The duration of sildenafil-induced DILI was significantly different among the 6 patients.The clinical symptoms of 4 patients were jaundice and intrahepatic cholestasis.The 6 patients included 3 cholestatic liver damage,4 of severe degree and 2 of mild degree.DILI was highly probably caused by sildenafil in 3 patients and probably in another 3 patients.After the onset of DILI,the patients discontinued sildenafil,and all of 6 patients were recovered and 2 of them were given liver-protecting drugs.Conclusion:Liver injury caused by sildenafil is rarely reported,and the mechanism is non-specific and unclear,which may be related to causing changes of liver tissue.It is recommended to regularly monitor liver function in patients who take sildenafil for a long time or at large dosages.
关键词
西地那非/药物性肝损伤/机制/肝功能/胆汁淤积Key words
sildenafil/drug-induced liver damage/mechanism/liver function/cholestasis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据