47例药物性肝衰竭患者临床分析  

An analysis of 47 cases of drug-induced liver failure

作　　者：刘晓燕[1,2] 王慧芬[2] 胡瑾华[2] 林方[2] 王海青[2] 刘娜[2] 梁金仙[2] 岳小敬[2] 崔志飞[2] 邓艳[2] 刘丽红[2] 

机构地区：[1]解放军军医进修学院,北京100853 [2]解放军第三○二医院肝衰竭治疗研究中心

出　　处：《肝脏》2008年第5期368-371,共4页Chinese Hepatology

摘　　要：目的探讨药物性肝衰竭的病因、肝衰竭类型及临床特征。方法回顾性总结我院收治的47例药物性肝衰竭患者临床资料,对损肝药物、临床特点、并发症及预后等方面进行分析。结果47例患者中,引起肝衰竭的前三类药物依次是中药(共17例,36.17%)、抗结核药(9例,19.15%)、抗菌药物(6例,12.77%);肝衰竭类型以急性(17.02%)、亚急性(80.85%)为主;并发症以肝性脑病、腹水为主;总治愈好转率为26.19%,无效死亡组的并发症包括肝性脑病、上消化道出血、腹水、自发性腹膜炎、肝肾综合征等发生率均高于治愈好转组,差异有显著统计学意义(P<0.01)。结论药物性肝衰竭的主要致病药物有中药(包括成药及汤剂)、抗结核药、抗菌药等,其治愈好转率低下,预后不良,用药过程中应予以监测。Objective To analyze the etiology, types and clinical features of drug-induced liver failure. Methods Characteristics of 47 patients with drug-induced liver failure in PLA 302 Hospital were retrospectively analysed, including drugs, clinical features, complication and prognosis. Results Of 47 cases , the three kinds of predominant drugs induced liver failure were the traditional Chinese medicine （36.17 % ）, antituberculotic （ 13.2 %） and antibacterials （ 12.77 % ）, and the two predominant types of liver failure were acute liver failure（17.02%） and subacute liver failure（80. 85%）. The main clinical manifestations of it were fatigue, nausea, vomiting and jaundice. The predominant complications of drug-induced liver failure are hepatic encephalopathy and ascites, the incidence rate of which in invalid group were more higher than in improvement group（P〈0. 01 ）. The total improvement rate in patients were 26.19%0. Conclusion The predomi- nant drugs induced liver failure are traditional Chinese medicine, antituberculotic and antibacterials in China. The prognosis of drug induced liver failure was poor. During the treatment, liver function test should be monitored.

关 键 词：药物性肝病 肝衰竭 临床特点 

分 类 号：R595.3[医药卫生—内科学] R575.3[医药卫生—临床医学]