Kassianides C, Nussenblatt R, Palestine A G, Mellow S D, Hoofnagle J H
Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892.
Dig Dis Sci. 1990 Jun;35(6):693-7. doi: 10.1007/BF01540169.
To assess the incidence of cyclosporine A-induced hepatotoxicity, we retrospectively analyzed liver biochemical test results in 59 patients with endogenous uveitis who received cyclosporine A. All patients had normal liver tests before treatment and had at least six determinations during a 6- to 36-month course of therapy with cyclosporine A at a dose of 2-10 mg/kg/day. Thirty-four (58%) patients developed at least one abnormality of liver tests, and 19 (32%) had a prolonged pattern of abnormalities. The usual abnormalities consisted of a mild, transient increase in alkaline phosphatase levels occasionally accompanied by slight elevations in serum bilirubin and aminotransferase activities. Peak alkaline phosphatase levels ranged from 125 to 243 units/liter and persisted for seven days to 48 months. Thus, biochemical evidence of mild cholestatic liver injury was common in patients receiving cyclosporine A. These abnormalities are usually self-limited and asymptomatic but may cause diagnostic difficulty if a preexisting liver disease is present.
为评估环孢素A所致肝毒性的发生率，我们回顾性分析了59例接受环孢素A治疗的内因性葡萄膜炎患者的肝脏生化检测结果。所有患者在治疗前肝功能检查均正常，且在接受剂量为2 - 10 mg/kg/天的环孢素A治疗的6至36个月疗程中至少进行了6次检测。34例（58%）患者出现至少一项肝功能检查异常，19例（32%）患者出现异常持续时间延长的情况。常见的异常表现为碱性磷酸酶水平轻度、短暂升高，偶尔伴有血清胆红素和转氨酶活性轻度升高。碱性磷酸酶峰值水平在125至243单位/升之间，持续7天至48个月。因此，轻度胆汁淤积性肝损伤的生化证据在接受环孢素A治疗的患者中很常见。这些异常通常是自限性的且无症状，但如果患者存在原有肝脏疾病，则可能导致诊断困难。
