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1例7岁男孩连续咳嗽7 d，家长给患儿喂食自行采摘并煎制的新鲜成熟苍耳子（用量不详）1次。喂食后第3天，患儿出现阵发性上腹痛，伴呕吐、厌食、乏力、嗜睡和低热，实验室检查示丙氨酸转氨酶（ALT）3 344 U/L，天冬氨酸转氨酶（AST）3 501 U/L，血清总胆红素（TBil）26.5 μmol/L，直接胆红素（DBil）19.0 μmol/L，血清白蛋白（ALB）32.8 g/L；血氨120 μmol/L。喂食后第6天，患儿乏力加重，易激惹，反应略迟钝，巩膜浅黄染，实验室检查示ALT 4 565 U/L，AST 4 335 U/L，TBil 32.9 μmol/L，DBil 23.4 μmol/L，ALB 30.2 g/L，血氨124 μmol/L。考虑为苍耳子中毒并致急性肝衰竭。给予血液净化（2次血浆置换、4 d血液透析滤过）和对症治疗后复查：ALT 1 043 U/L，AST 203 U/L，TBil 22.0 μmol/L，DBil 12.3 μmol/L，ALB 39.1 g/L；血氨36.3 μmol/L。停止血液净化治疗，继续对症治疗。2周后ALT 24 U/L，AST 35 U/L，TBil 13.8 μmol/L，DBil 4.6 μmol/L，ALB 47.3 g/L。“,”A 7-year-old boy coughed for 7 days. His parents fed him fresh and ripe cocklebur fruit (n Fructus Xanthii) once which was picked and fried by themselves (unknown dose). On the 3rd day after feeding the cocklebur fruit, the boy developed paroxysmal epigastric pain, with vomiting, anorexia, fatigue, drowsiness, and low fever. The laboratory tests showed alanine aminotransferase (ALT) 3 344 U/L, aspartate aminotransferase (AST) 3 501 U/L, serum total bilirubin (TBil) 26.5 μmol/L, direct bilirubin (DBil) 19.0 μmol/L, albumin (ALB) 32.8 g/L, and blood ammonia 120 μmol/L. On the 6th day after feeding the cocklebur fruit, the boy developed aggravated fatigue, irritability, slightly slow response, and light yellowish staining of sclera. The laboratory tests showed ALT 4 565 U/L, AST 4 335 U/L, TBil 32.9 μmol/L, DBil 23.4 μmol/L, ALB 30.2 g/L, and blood ammonia 124 μmol/L. Acute liver failure due to cocklebur fruit poisoning was considered. The boy received blood purification therapy (2 plasmapheresis and 4 days′ hemodiafiltration) and symptomatic treatments. The laboratory tests showed ALT 1 043 U/L, AST 203 U/L, TBil 22.0 μmol/L, DBil 12.3 μmol/L, ALB 39.1 g/L, and blood ammonia 36.3 μmol/L. The blood purification therapy was stopped and the symptomatic treatments was continued. The laboratory tests 2 weeks later showed ALT 24 U/L, AST 35 U/L, TBil 13.8 μmol/L, DBil 4.6 μmol/L, and ALB 47.3 g/L.n