急性药物性肝损害的临床分析和治疗探讨  

Acute Drug Induced Liver Injury:Clinical Analysis and Management

作　　者：王凡[1] 刘宾[1] 李莉[1] 樊宇靖[1] 

机构地区：[1]首都医科大学附属北京同仁医院消化内科,北京市100730

出　　处：《中国医院用药评价与分析》2007年第3期193-195,共3页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的：通过对我院近3年间临床诊断并住院治疗的急性药物性肝损害的病例回顾性分析总结，探讨急性药物性肝损害的临床特点和治疗方法。方法：收集2004年2月～2007年2月我院临床诊断并住院治疗的急性药物性肝损害39例，按照国际共识意见对急性药物性肝损害分型，对比还原型谷胱甘肽（阿拓莫兰）、阿拓莫兰联合复方甘草甜素（美能）治疗急性药物性肝损害的疗效。结果：39例急性药物性肝损害中肝细胞损害型22例（56．41％），胆汁淤积型10例（25．64％），混合型7例（17．95％）。10．26％（4／39）患者7天内肝功能恢复正常，46．15％（18／39）患者14天内肝功恢复正常，30．77％（12／39）患者21天内肝功恢复正常，7．69％（3／39）患者28天内肝功恢复正常，1例肝功异常持续34天以上，无死亡病例。结论：药物性肝损害国际共识标准的确规范了临床诊断，有助于肝损害的鉴别诊断，但其可操作性有待进一步实验，美能和阿拓莫兰联合治疗2周内可明显改善药物性肝损害表现及恢复肝功能。OBJECTIVE： To discuss the clinical features and management of acute drug induced hver injury by retrospectively reviewing patients who had been diagnosed as having acute drug induced liver injury and hospitalized in our hospital over the past 3 years. METHODS： A total of 39 cases diagnosed as having acute drug induced liver injury and hospitalized in our hospital during Feb 2004 and Feb 2007 were collected. The typing of liver injury was performed according to the international consensus criteria on acute drug induced liver injury. The efficacy was compared between glutathione （atomolan） and atomolan combined compound glycyrrhizin in the treatment of acute drug induced hver injury. RESULTS： Of the total 39 cases reviewed, 22 （56.41% ） had the hepatocellular damage type, 10 （25.64%） had cholestasis type, and 7 （17.95 % ） had mixed type of damage; the percentages for those who had their liver function brought to normal within 7 days, 14 days and 21 days were 10.26% （4/39）, 46.15% （18/39）and 30.77% （12/39）, respectively; 1 had continuous abnorma/liver function for over 34 days, but none of the cases died. CONCLUSION： The international consensus criteria have helped standardized the diagnosis of drug induced liver injury and are helpful for the differential diagnosis of livery injury, but its actual implementation remains to be further verified in the future experiments. Treated with compound glycyrrhizin combined atomolan within two weeks, the acute drug induced liver injury can be significantly improved and the liver function can be brought to normal.

关 键 词：急性药物性肝损害 复方甘草甜素 还原型谷胱甘肽 

分 类 号：R575[医药卫生—消化系统]