华法林诱导的奇异同位素肝细胞损伤:一种可逆且不常见的发生
Usamah Al-Anbagi1, Aiat O Elmabrouk2, Aia A Elimam2
1Internal Medicine, Hamad Medical Corporation, Doha, QAT.
Cureus
|December 15, 2025
概括
华法林可以在开始治疗后不久引起罕见但严重的肝损伤 (肝毒性). 及时停止华法林并切换为直接口服抗凝剂 (DOAC) 导致深静脉血栓症 (DVT) 患者完全康复.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 药理学 药理学是指药理学的学科.
- 内部医学 内部医学
背景情况:
- 华法林是一种常用的口服抗凝剂,用于预防和治疗血栓栓塞事件.
- 肝毒性是华法林治疗的极为罕见的副作用.
- 早期识别药物诱导的肝损伤对于患者的治疗结果至关重要.
研究的目的:
- 报告一个急性肝细胞损伤的病例,其次是华法林启动.
- 为了强调认识到华法林诱导的肝毒性的重要性.
- 通过切换到直接口服抗凝剂来证明成功的管理和恢复.
主要方法:
- 一份病例报告,一名41岁的男性患者在开始服用华法林后出现急性肝损伤.
- 排除其他潜在的肝炎原因,包括病毒性和自身免疫性.
- 在停用华法林和转换为阿皮克萨班后,对肝功能测试 (ALT,AST) 和临床反应的监测.
主要成果:
- 患者在华法林治疗深静脉血栓症 (DVT) 开始后24小时内发生了急性肝细胞损伤.
- 肝酶显著升高 (ALT,AST),在停止使用华法林后迅速改善.
- 在切换到直接口服抗凝剂 (DOAC) 艾皮克萨班后,观察到肝酶的完全正常化.
结论:
- 华法林可以引起罕见但可逆的肝毒性,即使在没有先前风险因素的患者中也是如此.
- 及时识别和停止华法林治疗对于控制这种不良影响至关重要.
- 过渡到DOAC是一种安全有效的策略,用于患有华法林诱导的肝损伤的患者.
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