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长期异维 A 酸治疗不会导致实质肝脏变化:50 例患者的超声研究。

Long-term isotretinoin use does not cause parenchymal liver change: Ultrasonographic study in 50 patients.

机构信息

Faculty of Medicine, Department of Dermatology, Karabuk University, Karabuk, Turkey.

Faculty of Medicine, Department of Radiology, Karabuk University, Karabuk, Turkey.

出版信息

Dermatol Ther. 2019 Sep;32(5):e13012. doi: 10.1111/dth.13012. Epub 2019 Jul 5.

Abstract

The effect of isotretinoin on liver enzymes and lipid profile is reported as rare and reversible. However, possible parenchymal liver changes have not been demonstrated so far. The aim of this study was to evaluate the ultrasonography findings of the liver in patients receiving long-term isotretinoin therapy. We examined ultrasonographic findings of the liver together with serum alanin aminotransferase (ALT), aspartate aminotransferase (AST), and total cholesterol and triglyceride levels in 50 consecutive patients who have taken isotretinoin 10-40 mg daily for at least 6 months between January and December 2017. Of 50 patients examined, 40 were female, 10 were male. Mean age of the patients was 24.8 years. Five patients aged between 42 and 62 were found to have Grade 1 hepatosteatosis. Despite a moderate elevation, serum ALT, AST, and total cholesterol and triglyceride levels were in normal range in these five patients. Moreover, one patient had elevated ALT, and one another patient had elevated triglyceride level although both have normal liver ultrasonographic findings. Isotretinoin did not cause parenchymal liver changes as well as serum ALT, AST, and total cholesterol and triglyceride levels in patients who take it 10-40 mg daily for at least 6 months.

摘要

异维 A 酸对肝酶和血脂谱的影响被报道为罕见且可逆转的。然而,迄今为止尚未证明可能存在实质肝变化。本研究旨在评估长期接受异维 A 酸治疗的患者的肝脏超声检查结果。我们检查了 50 例连续患者的肝脏超声检查结果,这些患者在 2017 年 1 月至 12 月期间每天服用 10-40mg 的异维 A 酸至少 6 个月,同时检查了血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)和总胆固醇及甘油三酯水平。50 例患者中,40 例为女性,10 例为男性。患者的平均年龄为 24.8 岁。5 例年龄在 42-62 岁之间的患者被发现患有 1 级肝脂肪变性。尽管 ALT、AST、总胆固醇和甘油三酯水平中等升高,但这 5 例患者的水平均在正常范围内。此外,1 例患者 ALT 升高,另 1 例患者甘油三酯水平升高,但两者的肝脏超声检查结果均正常。异维 A 酸在每天服用 10-40mg 至少 6 个月的患者中既没有引起实质肝变化,也没有引起 ALT、AST、总胆固醇和甘油三酯水平的变化。

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