Ames D J, Bhathal P S, Davies B M, Fraser J R, Gibson P R, Roberts S
Department of Psychiatry, University of Melbourne, Royal Melbourne Hospital, Victoria, Australia.
Aust N Z J Med. 1990 Apr;20(2):193-5. doi: 10.1111/j.1445-5994.1990.tb01309.x.
Of 14 patients taking tetrahydroaminoacridine (THA) for the trial treatment of Alzheimer's disease, five developed mildly abnormal liver function tests. Four asymptomatic patients with persistently abnormal serum transaminase levels underwent liver biopsy, in order to determine the nature of the hepatic lesions. One subject had granulomatous hepatitis while three showed focal, predominantly centrilobular, liver cell necrosis and mild fatty change. One of the latter showed both tissue and peripheral blood eosinophilia. The liver function tests of the fifth patient, who was symptomatic, became normal after reduction of the dose of THA so he did not undergo biopsy. These findings suggest that the pathogenic mechanisms for THA-induced liver injury are heterogeneous ranging from hypersensitivity reactions to direct injury, and including combinations of the two. Patients receiving THA for treatment of Alzheimer's disease need regular monitoring of liver function.
在14名服用他克林（THA）进行阿尔茨海默病试验性治疗的患者中，有5名肝功能检查出现轻度异常。4名血清转氨酶水平持续异常的无症状患者接受了肝活检，以确定肝脏病变的性质。1名受试者患有肉芽肿性肝炎，而3名表现为局灶性、主要为小叶中心性的肝细胞坏死和轻度脂肪变性。后者中有1名在组织和外周血中均出现嗜酸性粒细胞增多。第5名有症状的患者在减少THA剂量后肝功能检查恢复正常，因此未接受活检。这些发现表明，THA诱导肝损伤的致病机制是异质性的，从超敏反应到直接损伤，包括两者的组合。接受THA治疗阿尔茨海默病的患者需要定期监测肝功能。
