| 摘要: |
| ［摘要］ 目的 通过分析药物性肝损伤（DILI）的临床特点，以提高对药物性肝损伤的认识及重视。方法 连续收集98例药物性肝损伤患者，根据服药史、临床表现、肝功能、血清肝炎病毒标志物、B超及停用已知或可疑药物后疾病的转归特点等指标进行分析。结果 药物性肝损伤无明显性别差异，年龄以40岁以上者多见，占75.51%。导致药物性肝损伤前三位药物依次为中草药（41.84%）、解热镇痛消炎药（14.29%）、抗生素（11.22%）。肝功能检测几乎都有转氨酶升高，以谷丙转氨酶（ALT）升高为主（92.86%），ALT≥500 U/L者占59.18%。胆红素升高占85.71%，以直接胆红素升高为主（64.29%）。发生药物性肝损伤的时间因药物种类不同而异，最快发生在用药后5 d，最慢发生在用药后10月余，多发生在3个月内。药物性肝损伤预后良好，无死亡病例，及时停药为治疗的关键。结论 药物性肝损伤的临床表现无特异性，以肝细胞损伤及胆汁淤积为主要表现，详细询问用药史至为重要，单纯药物性肝损伤预后良好。 |
| 关键词: 药物性肝损伤 临床分析 预后 |
| DOI：10.3969/j.issn.1674-3806.2016.01.13 |
| 分类号:R 575 |
| 基金项目: |
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| Clinical analysis on 98 cases of drug induced liver injury |
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LIAO Shu-lan, LIANG Lie-xin
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Department of Gastroenterology, the Second Affiliated Hospital of Guangxi University of Science and Technology, Liuzhou 545006, China
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| Abstract: |
| ［Abstract］ Objective To analyze the clinical characteristics of drug-induced liver injury(DILI) and to deepen the understanding and recognition of DILI.Methods A total of 98 patients with DILI were collected consecutively. The prognosis was analyzed after withdrawing known or suspected drugs according to the patients′ history of taking medicine, clinical situation, liver function, serum hepatitis virus markers and B ultrasound.Results In these patients, DILI had no significant differences in gender. The patients over 40 years old were more common, accounting for 75.51%; The mainly responsible drugs are Chinese traditional medicine(41.84%), antipyretic analgesic anti-inflammatory drugs(14.29%) and antibiotics(11.22%). Liver function tests showed elevated transaminase, with high level of ALT(92.86%), of which 59.18% was more than 500 U/L; Elevated bilirubin accounted for 85.71%, of which 64.29% was direct bilirubin; The lasting time of drug-induced liver injury varied with different types of drugs. The fastest one occurred 5 days after the treatment and the slowest one occurred 10 months after the treatment, with an average being 3 months. The prognosis of drug-induced liver injury was good, without dead cases.Conclusion Clinical features of drug-induced liver injury are not specific, with hepatic cell injury and cholestasis in bile as the main manifestations. It is important to inquire the history of using drugs in detail and withdraw the related medication timely. The prognosis of drug-induced liver injury is good. |
| Key words: Drug induced liver injury（DILI） Clinical analysis Prognosis |
