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药物性肝损害88例回顾性分析
Retrospective Analysis of 88 Patients with Drug induced Liver Injury
  
DOI:
中文关键词:  药物性肝损害  回顾性分析  预后
英文关键词:Drug induced liver injury  Retrospective analysis  Prognosis
基金项目:江苏高校优势学科建设工程资助项目(公共卫生与预防医学)
作者单位
张叶飘 南京医科大学公共卫生学院(南京 211166) 
赛娜瓦尔 南京医科大学公共卫生学院(南京 211166)②江苏省苏北人民医院。 
谢修强 南京医科大学公共卫生学院(南京 211166)②江苏省苏北人民医院。 
唐少文 南京医科大学公共卫生学院(南京 211166)②江苏省苏北人民医院。 
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中文摘要:
      摘 要 目的:分析住院治疗的药物性肝损害(DILI)患者的临床特征,为预防和治疗DILI提供基础。方法:回顾性调查2011年9月~2013年12月某三甲医院肝病科收治的DILI住院患者资料,分析其人口学特征、原发疾病、用药情况、肝功能检查、治疗及转归。 结果:共纳入88个DILI病例(男37例,女51例),平均年龄(58.1±15.4)岁。致DILI的药物主要为中草药或中成药、抗菌药物、抗结核药物、肿瘤化疗药、心血管系统药物等。68.2%为口服给药,25%为静脉用药。肝功能检测指标均异常,其中以ALT 升高为最常见(79.4%)。分型结果显示肝细胞损害型占25.0%、胆汁淤积型占51.1%、混合型占23.9%。经停用可疑药物,给予保肝、退黄等治疗后,35.2%患者治愈,61.4%患者好转。结论:致肝损伤的药物种类繁多,肝功能以ALT异常为主,临床医生用药时要严格把握用药指征,并积极监测肝功能,预防和减少DILI的发生。
英文摘要:
      ABSTRACT Objective:To analyze clinical features of patients with drug induced liver injury (DILI) and provide basis for prevention and treatment. Methods: Retrospectively analysis was conducted based on inpatients’ data of division of liver diseases in a grade A class three hospital from Sept. 2011 to Dec. 2013. And demographic characters, primary disease, medication history, liver function examination, treatment, and outcome were described. Results:88 DILI patients’ data were analyzed (37 males)with mean age among 58.1±15.4 years. The etiological drugs of DILI primarily were herbal medicine, antibiotics, anti tuberculosis drugs, anticancer drugs, and cardiovascular drugs.68.2% administration route was oral, and 25% was intravenous administration. The results of liver function tests in DILI patients were abnormal, and elevation of ALT was the most common (79.4%). Among 88 DILI patients,25.0%were hepatocellular damage type,51.1% were cholestatic damage type and 23.9% were the mixed type.The overall cure rate was 35.2%, and the improvement rate was 61.4%. Conclusion: Various kinds of drugs could cause liver injury. And elevation of ALT was the most common. Liver function should be monitored when suspected drugs are prescribed.
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