摘要
目的:探讨药物性肝损伤的病因、临床特点及预后,为临床合理用药,防治药物性肝损伤提供参考。方法:收集2007~2016年本院152例诊断为药物性肝损伤的住院病例,对用药史、临床表现与分型、肝功能检查值、治疗和转归等进行回顾性分析,并评价药物与肝损伤的因果关系。结果:引起药物性肝损伤的前5位药品分别是:中草药及中成药、抗菌药物、非甾体抗炎药、抗肿瘤药和调血脂药;给药途径以口服为主。仅62.5%的患者存在明显临床症状,表现为食欲不振、乏力、腹痛、皮肤巩膜黄染、恶心等非特异性症状;肝损伤以肝细胞型最为常见(57.9%)。肝功能检查值异常,以ALT升高最多见(占87.5%)。药物性肝损伤患者预后较好,治愈和好转率达96.7%。94.7%的病例因果关系为极可能和很可能。结论:引起药物性肝损伤的药物种类繁多,临床表现无特异性。因此临床医生在使用药物治疗时务必提高安全用药意识,注意药品不良反应尤其是药物性肝损伤,及早预防和诊治。
Objective：To investigate the etiology of drug-induced liver injury and clinical eharcteristics and prog- nosis. Methods： 152 diagnosed cases of drug-induced liver injury in the hospital were collected from 2007 to 2016. The medication history, clinical manifestations and classification, liver function test, treatment and outcome were analyzed ret- rospectively. The causal relationship between the drugs and liver injury was evaluated. Results：The most common top 5 drugs causing liver injury were Chinese herb medicine and Chinese patent medicine, antibacterial agents, non-steroidal an- ti-inflammatory drugs, antineoplastic and regulating blood-lipid drugs. Only 62.5% of the patients had obvious symptoms, which manifested nonspecific symptoms such as anorexia, fatigue, abdominal pain, yellowing of skin and nausea. Hepato- cellular injury was the most common type of liver injury（57.9% ）. The most common liver function examination value was ALT elevation（87.5% ）. The drug-induced liver injury usually had a better prognosis than other liver diseases, and the o- verall cure and improvement rate was 96.7%. 94.7% cases＇ causal relationship were much more likely or probably. Con-clusion： Most kinds of drugs could induce liver injury. It was non-specific in clinial manifestations of liver injury. The cli- nician must enhance awareness of rational drug using, and pay attention to adeverse drug reaction especially drug-induced liver injury. Given prevention and early diagnosis and treatment as soon as possible.
出处
《药物流行病学杂志》
CAS
2017年第6期413-416,共4页
Chinese Journal of Pharmacoepidemiology
关键词
药物性肝损害
临床分析
安全用药
Drug-induced liver injury
Clinical analysis
Safe medication
