胺碘酮静脉滴注致严重肝损害

1名男性53岁患者，在接受冠状动脉搭桥及室壁瘤切除术后，给予心血管药物，利尿药和抗感染药物。术后第3天患者出现室性心动过速。先后静脉注射胺碘酮75mg和150mg，之后以胺碘酮600mg加入0．9％氯化钠注射液50ml中微量泵入（3ml／h）。术后第4～6天以及第7天胺碘酮的每日剂量分别为864mg和108mg，以微量泵入。患者术前的ALl、和TBil分别为23U／L和16μmol／L。术后第7天的ALT，AST和TBil分别为364U／L，325U／L和35．8μmol／L。术后第9天ALT，AST和TBil分别为2667U／L，2418U／L和53．9μmol／L。停用胺碘酮，其它药物继续使用，并给予保肝治疗，患者的ALT，AST和TBil分别降为24U／L，20U／L和18．7μmol／L。

Severe hepatic injury following intravenous infusion of amiodarone

A 53-year-old man who had received coronary artery bypass graft and ventricular aneurysmectomy was administered with cardiovasculcer drugs, diuretics, and anti-infective drugs. On day 3 after surgery, he developed ventricular tachycardia. The patient was administered with amiodarone 75 mg and subsequent 150 mg intravenously, and then he was infused with a minute dose of amiodarone （600 mg mixed with 50 ml of sodium chloride 0.9% ） in the rate of 3 ml/h via infusion pump. On day 4 - 6 and on day 7 after surgery, the daily dosages of amiodarone were 864 mg and 108 mg, respectively, and they were given with a minute dose via infusion pump. Before surgery, his ALT and TBil levels were 23 U/L and 16 μmol/L, respectively. On day 7 after surgery, his ALT, AST, and TBil levels were 364 U/L, 325 U/L, and 35.8 μmol/L, respectively. On day 9 after surgery, his ALT, AST, and TBil levels were 2 667 U/L, 2 415 U/L, and 53.9 μmol/L, respectively. Amiodarone was discontinued and other medications were continued. The patient was given liver-protective treatment. His ALT, AST, and TBil levels decreased to 24 U/L, 20 U/L, and 18. 7μmol/L, respectively.