Smith G N, Piercy W N
Department of Obstetrics and Gynaecology, Queen's University, Kingston General Hospital, Canada.
Am J Obstet Gynecol. 1995 Jan;172(1 Pt 1):222-4. doi: 10.1016/0002-9378(95)90123-x.
A case of hepatotoxicity in a multiparous Native woman, who was begun on a regimen of methyldopa for control of chronic hypertension, is described. The patient was first seen for clinical evidence of hepatotoxicity approximately 3 weeks after initiation of treatment. At presentation the aspartate aminotransferase level was 1800 IU/L and alanine amniotransferase was 2415 IU/L. There was also a significant prolongation of clotting time, which required therapy. Resolution of symptoms occurred after cessation of the medication. Although methyldopa is considered to have a wide margin of safety in the treatment of chronic hypertension in pregnancy, potentially serious adverse effects can occur. It is important to monitor serum aminotransferase levels after initiation of methyldopa therapy.
本文描述了一例多产的原住民女性发生肝毒性的病例，该患者因控制慢性高血压而开始服用甲基多巴。患者在开始治疗约3周后首次因肝毒性的临床证据就诊。就诊时，天冬氨酸转氨酶水平为1800 IU/L，丙氨酸转氨酶为2415 IU/L。凝血时间也显著延长，需要进行治疗。停药后症状得到缓解。尽管甲基多巴在治疗妊娠期慢性高血压方面被认为具有广泛的安全范围，但仍可能发生潜在的严重不良反应。在开始甲基多巴治疗后监测血清转氨酶水平很重要。
