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)
毒理性
丁丙诺啡治疗与治疗期间血清酶水平升高的低发生率有关，尽管研究的群体（阿片类药物依赖者）通常存在并发的慢性肝病，这会使得评估复杂化。尽管如此，在丁丙诺啡（单独或与纳洛酮联合）治疗期间ALT升高的发生率与比较组（美沙酮）相比最小或没有更高。
此外，有几份报告和病例系列提到，在开始使用丁丙诺啡后的2到20周内出现了急性、临床上明显的肝损伤，通常（但不总是）在误用和静脉注射舌下片后发生。然而，一些病例发生在否认静脉使用并按照常规舌下剂量的患者中。在大多数病例中，血清酶水平升高的模式是肝细胞型的，临床表现类似于急性毒性肝坏死。没有出现免疫过敏特征（发热、皮疹和嗜酸性粒细胞增多），也未检测到自身抗体。几乎所有出现这种损伤的患者都同时患有慢性丙型肝炎，其中几例似乎随着急性肝损伤而解决了慢性感染（案例1）。值得注意的是，大多数患者能够在没有复发的情况下继续使用丁丙诺啡，其中一些人承认继续静脉滥用。
可能性评分：B[HD]（可能是临床上明显肝损伤的罕见原因，通常与过量或误用有关）。
Buprenorphine therapy has been associated with a low rate of serum enzyme elevations during treatment, although the populations studied (opioid dependent) often have coexisting chronic liver diseases which complicate such assessments. Nevertheless, rates of ALT elevations during treatment with buprenorphine (with or without naloxone) have been minimally or no greater than with comparator arms (methadone).
In addition, there have been several reports and case series of acute, clinically apparent liver injury arising within 2 to 20 weeks of starting buprenorphine, usually (but not invariably) following misuse and intravenous administration of sublingual tablets. However, some cases occurred in patients who denied intravenous use and were on conventional sublingual doses. In most cases, the pattern of serum enzyme elevations was hepatocellular and the presentation resembled acute toxic hepatic necrosis. Immunoallergic features (fever, rash and eosinophilia) were not present, nor were autoantibodies detected. Almost all patients with this injury had concurrent chronic hepatitis C, and several appeared to resolve the chronic infection with the acute liver injury (Case 1). Strikingly, most patients were able to continue buprenorphine without recurrence, some of whom admitted to continued intravenous abuse.
Likelihood score: B[HD] (likely rare cause of clinically apparent liver injury usually associated with overdose or misuse).
来源:LiverTox
