摘要
目的调查分析我国多中心急性重症药物性肝损伤住院诊治情况。方法制订统一的急性重症药物性肝损伤调查表，收集全国41家医院2000年至2006年间住院诊断的急性重症药物性肝损伤病例。采用急性药物性肝损伤国际共识意见的量化评分系统和急性肝功能衰竭诊断标准，纳入分析我国重症药物性肝损伤住院诊治病例数及其年度分布、治疗方法和住院转归、可疑肝毒性的药物种类。结果共收集到调查表格340份，符合重症药物性肝损伤诊断标准的病例共213例。患者平均年龄为（44±18）岁，男女比例为1：1．01。住院期间死亡82例（38．50％），病情恶化而自动出院77例（36．15％），治愈14例（6．57％），病情好转40例（18．78％），7例（3．29％）行肝移植手术。导致重症肝损伤前3位的药物分别为中草药（27．23％，58／213）、抗结核药物（25．82％，55／213）及其他抗菌药物（11．74％，25／213）。结论急性重症药物性肝损伤致死率高，中草药和抗结核药物是导致我国重症药物性肝损伤以及死亡的主要病因，需要加强这些药物的临床监测。
Objective To investigate and analyze the diagnosis and treatment of hospitalized patients with acute severe drug-induced liver injury in multi-centers of China. Methods A unified severe acute drug-induced liver injury questionnaire was formulated. From 2000 to 2006, the cases of hospitalized diagnosed severe acute drug-induced liver iniury were collected in nationwide 41 hospitals. The international consensus criteria of causality assessment of drug-induced liver injury and American Association for the Study of Liver Diseases （AASLD） criteria of acute liver failure were applied to analyze the case number, annual distribution, treatment and hospitalization outcomes, suspected hepatotoxic drugs of severe drug-induced liver injury. Results A total of 340 questionnaires were collected, and 213 cases complied with the diagnostic criteria of severe drug-induced liver injury. The average age was （44±18） years old, and the ratio of male to female was 1 to 1.01. A total of 82 patients （38.50 % ） died during hospitalization, 77 patients （36.15%） discharged by own request since the disease deteriorated, 14 cases （6.57%） were cured, and 40 cases （18.78%） got better. Seven patients （3. 29%） underwent liver transplantation. The three top medicines that caused severe liver injury were Chinese herbal medicine （27.23%, 58/213）, antitubercular drugs （25.82%, 55/213） and other antibacterial medicine （11. 74%,25/213）. Conclusions The mortality of acute severe drug- induced liver injury was high. Chinese herbal medicine and anti-tuberculosis drugs were main etiology of acute severe drug-induced liver injury in our country. Clinical monitoring of these medicines should be strengthened.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2013年第2期80-83,共4页
Chinese Journal of Digestion
关键词
肝炎
中毒性
多中心研究
中草药
抗结核药
Hepatitis, toxic
Multicenter study
Drugs, Chinese herbal
Antitubercular agents
