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1例22岁初诊成人斯蒂尔病女性患者经甲泼尼龙抗炎以及护肝、护胃等治疗1周,关节痛及体温控制不理想,遂加用尼美舒利100 mg口服,2次/d。用该药前天冬氨酸转氨酶(AST)60 U/L,丙氨酸转氨酶(ALT)50 U/L,肾功能正常。9 d后复查,AST 458 U/L,ALT 450 U/L,怀疑为尼美舒利引起的药物性肝损害,故停用该药并加强护肝治疗。11 d后复查,AST 221 U/L,ALT 97 U/L。因病情需要,再次给予尼美舒利100 mg口服,2次/d。再次用药的第4天晨患者出现排尿困难,血清尿素11.2 mmol/L,肌酐109μmol/L,尿酸435μmol/L;第5天AST 542 U/L,ALT 104 U/L。考虑为尼美舒利引起的肝肾功能损害,停用该药。4 d后患者肾功能指标恢复正常;2周后AST 47 U/L,ALT32 U/L。
One case of 22-year-old adult patients with Steller’s disease were treated with methylprednisolone anti-inflammatory and hepatoprotective drugs such as Hugan and Huwei for 1 week. The arthralgia and body temperature were not controlled well. Nimesulide 100 mg orally and twice / d. The drug before aspartate aminotransferase (AST) 60 U / L, alanine aminotransferase (ALT) 50 U / L, normal renal function. 9 d after the review, AST 458 U / L, ALT 450 U / L, suspected to be caused by nimesulide drug-induced liver damage, it disables the drug and strengthen liver protection. After 11 d review, AST 221 U / L, ALT 97 U / L. Because of illness needs, again given nimesulide 100 mg orally, 2 times / d. On the fourth day of re-medication, dysuria occurred on the morning of the fourth day. Serum urea 11.2 mmol / L, creatinine 109 μmol / L, uric acid 435 μmol / L and AST 542 U / L and ALT 104 U / L on the fifth day. Consider nimesulide liver-kidney dysfunction, disable the drug. After 4 days, the renal function returned to normal; AST was 47 U / L and ALT32 U / L after 2 weeks.