依地酸钙钠致肝功能异常的临床分析和因果关系评估

目的：了解依地酸钙钠致肝功能异常的发生情况并进行因果关系评估。方法：收集2015年1月1日-2019年6月30日使用依地酸钙钠进行驱铅治疗的住院患者，对肝功能异常的病例进行回顾性分析，并对ALT（或AST）>1.5倍参考值上限（ULN）的病例釆用RUCAM量表评估因果关系。结果：85例使用依地酸钙钠的患者中，符合纳入标准的肝功能异常患者共有14例，均为ALT（或AST）超过ULN，肝功能异常分级均为1级。8例应用RUCAM量表评估因果关系，极可能者3例，很可能者4例，可能者1例。14例保肝治疗后9例肝功能恢复正常、4例好转、1例ALT轻度上升。结论：依地酸钙钠导致肝损伤的程度轻，及时进行保肝治疗预后较好。

Clinical analysis and causality assessment of liver dysfunction caused by calcium disodium edetate

OBJECTIVE To investigate the incidence and causal relationship of liver dysfunction induced by calcium edetate sodium.METHODS A retrospective analysis of cases of abnormal liver function was performed in hospitalized patients treated with calcium edetate sodium for lead repellent on January 1,2015,and RUCAM scale was used to assess causality in cases of ALT (or AST) >1.5 times the upper limit of reference (ULN).RESULTS A total of 14 patients with liver dysfunction were enrolled into this study and all of their manifestations were ALT (or AST) >ULN.Using grading standard of liver dysfunction,all the 14 patients were diagnosed as mild liver injury.A total of 8 patients with ALT (or AST) >1.5 ULN were assessed by RUCAM scale,3 patients were classified as "highly probable" and 4 patients were classified as "probable" and 1 patients were classified as "possible".After hepatoprotective therapy,9 patients' liver function was recovered to the normal level and 4 patients' liver function improved,but 1 patients' ALT increased slightly.CONCLUSION The degree of liver injury induced by calcium sodium edetate is mild,and the prognosis of timely hepatoprotective treatment is better.