摘要1例35岁男性患者因右顶叶脑出血破入脑室及双侧气胸，静脉滴注哌拉西林他唑巴坦钠（4.5 g、1次/8 h）、替考拉宁（400 mg、1次/12 h）、甘露醇（125 ml、3次/d）、埃索美拉唑钠（40 mg、1次/d）和氨溴索（45 mg、2次/d）。第3天，实验室检查示ALT 99 U/L，AsT 120 U/L，γ-GT 299 U/L， ALP 87 U/L，替考拉宁改为400 mg、1次/d，给予还原型谷胱甘肽2.4 g静脉滴注、1次/d。次日转氨酶继续升高，停用埃索美拉唑钠，加用异甘草酸镁200 mg静脉滴注、1次/d，肠外营养改为肠内营养。第8天复查，ALT 430 U/L，AsT 262 U/L，γ-GT 456 U/L，ALP 164 U/L。考虑替考拉宁引起的药物性肝损伤。停用替考拉宁，改用万古霉素1 g静脉滴注、1次/12 h，其他药物继续使用。停用替考拉宁第23天复查，ALT 130 U/L，AsT 51 U/L，γ-GT 49 U/L，ALP 94 U/L。

abstractsA 35-year-old male patient with right parietal lobe cerebral hemorrhage broke into the ventricle and bilateral pneumothorax received IV infusions of tazobactam sodium/piperacillin sodium 4. 5 g every 8 hours,teicoplanin 400 mg every 12 hours,mannitol 125 ml thrice daily,esomeprazole sodium 40 mg once daily and ambroxol 45 mg twice daily. On day 3,laboratory tests showed the following results:alanine aminotransferase( ALT)99 U/L,aspartate aminotransferase( AsT)120 U/L,γ-glutamine transferase(γ-GT)299 U/L,alkaline phosphatase( ALP)87 U/L. The dosage of teicoplanin was changed to 400 mg once daily. He was given an IV infusion of reduced glutathione 2. 4 g once daily. The next day,aminotransferase levels continued to elevate,esomeprazole sodium was stopped and he received an IV infusion of magnesium isoglycyrrhizinate 200 mg once daily,parenteral nutrition was changed to enteral nutrition. On day 8,his liver function reexamination showed the following levels:ALT 430 U/L,AsT 262 U/L,γ-GT 456 U/L, ALP 164 U/L. Acute drug-induced liver injury induced by teicoplanin was considered. The teicoplanin was stopped. His therapy was changed into vancomycin 1 g every 12 hours and other drugs were continued. Twenty-three days after teicoplanin withdrawal,the values of ALT,AsT,γ-GT and ALP were 130 U/L, 51 U/L,49 U/L,and 94 U/L,respectively.