摘要
甲巯咪唑作为抗甲状腺药物因其良好的药效被广泛应用,其主要的副作用是恶心、呕吐、皮疹、皮肤瘙痒等,严重副作用有粒细胞缺乏、再生障碍性贫血、抗中性粒细胞胞质抗体相关性血管炎、肝损害等,其中肝损害比较少见。甲巯咪唑引起肝损害的类型可为肝细胞型、胆汁淤积型、混合型。目前甲巯咪唑引起肝损害的发病机制不明,既往认为机体变态反应是其主要的发病机制,现认为免疫反应和其代谢产物可能是引起肝损害的主要原因,而且有研究发现在饮酒、其他药物的联用以及存在其他疾病时服用甲巯咪唑将会增加肝损害的发生率。发生肝损害后,最关键的治疗措施是停药,其次是换用其他药物治疗甲亢、保肝、糖皮质激素、人工肝支持技术等。
Methimazole is widely used as an antithyroid drug because of its good efficacy. The main side effects of it are nausea, vomiting, rash, and itchy skin, and serious side effects include neutropenia, aplastic anemia, antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV), and liver damage. Among them, liver damage is relatively rare. The types of liver damage caused by methimazole are mainly hepatocellular type, cholestatic type, and mixed type. At present, the pathogenesis of liver damage caused by methimazole is unknown. In the past, allergic reaction was considered to be its main pathogenesis. Nowadays, immune response and its metabolites are considered to be the main causes of liver damage. And studies have found that taking methimazole in alcohol, combined use of other drugs, and other diseases will increase the incidence of liver damage. After liver damage, the most important treatment is to discontinue using methimazole, followed by anti-hyperthyroidism treatment, hepatoprotective drugs, and glucocorticoids, artificial liver support technology.
作者
曾白梅
袁灵
林世德
ZENG Bai-mei;YUAN Ling;LIN Shi-de(Department of Infectious Disease,Affiliated Hospital of Zunyi Medical College,Zunyi 563000,Guizhou,CHINA)
出处
《海南医学》
CAS
2018年第24期3530-3533,共4页
Hainan Medical Journal
基金
国家自然科学基金(编号:81160067
81460124)
作者简介
通讯作者:林世德。E—mail:linshide6@hotmail.com
