Stricker B H, Blok A P, Bronkhorst F B
Liver. 1986 Apr;6(2):63-72.
Glafenine was associated with hepatic injury in 38 cases. The causal relationship was assessed on the basis of the temporal relationship with drug use, course and exclusion of other causes. In 27 cases a causal relationship was considered likely, i.e. 'probable' (12 cases) or 'possible' (15 cases), whereas in 11 cases it was either unlikely or unclassifiable. In both the 'probable' and 'possible' groups 60-70% of individuals were women. Jaundice was present in three-quarters of cases in both groups. Eosinophilia was more frequent in the group of 'probable' cases, and this group had the highest case-fatality rate (42%). Onset varied from 2 days (after a rechallenge) to 8 months, but most cases appeared between 2 weeks and 4 months after starting therapy. Histology in 22 cases showed a predominantly hepatocellular pattern, varying from spotty panlobular necrosis, centrilobular and (sub)massive necrosis (acute pattern) to fibrosis and cirrhosis (chronic pattern). The chemical structure of glafenine and the clinicopathological pattern it induces resemble that of cinchophen. The incidence is unknown. Either metabolic idiosyncrasy or an immunoallergic mechanism seems to be responsible.
格拉非宁与38例肝损伤有关。根据与用药的时间关系、病程以及排除其他病因来评估因果关系。27例被认为可能存在因果关系，即“很可能”（12例）或“有可能”（15例），而11例则不太可能或无法分类。在“很可能”和“有可能”两组中，60 - 70%的个体为女性。两组中四分之三的病例出现黄疸。嗜酸性粒细胞增多在“很可能”病例组中更常见，且该组的病死率最高（42%）。发病时间从2天（再次用药后）至8个月不等，但大多数病例在开始治疗后2周内至4个月出现。22例的组织学表现主要为肝细胞型，从散在的全小叶坏死、小叶中央及（亚）大块坏死（急性型）到纤维化和肝硬化（慢性型）不等。格拉非宁的化学结构及其诱发的临床病理类型与辛可芬相似。发病率未知。代谢特异反应或免疫过敏机制似乎是病因。
