药物性肝损害临床分析(附60例报告)  

Clinical analysis of drug-induced liver injury

作　　者：唐源淋[1] 雷姗[1] 崔生达[1] 朱微[1] 陈村龙[1] 蓝琳[1] 刘思德[1] 肖冰[1] 智发朝[1] 张亚历[1] 姜泊[1] 程天明[1] 

机构地区：[1]南方医科大学南方医院消化科广东省胃肠疾病重点实验室

出　　处：《中国中西医结合消化杂志》2011年第3期175-178,共4页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：[目的]探讨引起药物性肝损害的常见药物,分析药物性肝损害的临床特点、治疗及其疗效。[方法]回顾性分析2005年1月~2009年12月60例药物性肝损害患者的临床资料。[结果]5年内60例药物性肝损害中,肝细胞损伤型30例（50.0%）,胆汁瘀积型18例（30.0%）,混合型12例（20.0%）。均有明确的服用药物史,且发生时间多在服药后2~4周。以中药、中成药、抗生素、抗甲状腺药、抗结核药常见。临床症状以上腹不适、乏力、纳差、恶心、呕吐、黄疸为主,肝功能检查有不同程度的转氨酶、胆红素、碱性磷酸酶等指标升高。经停药,给予护肝及对症支持治疗,必要时糖皮质激素治疗,肝损害大多可恢复。[结论]在临床工作中应重视药物的不良反应,避免肝损害的发生。一旦发生了肝损害,要给予积极有效治疗。[Objective]To investigate the common drugs that induce liver injury and analyse drug-induced liver injury about its clinical characteristics,treatment and efficacy.[Methods]The clinical data of 60 patients with drug-induced hepatitis from January 2005 to December 2009 were retrospectively analyzed.[Results]Among 60 patients with liver injury during 5 years,the hepatocellular pattern accounted for 30 cases（50%）,the cholestatic pattern 18 cases（30%）,the mixed type 12 cases（20%）.All the 60 cases had specific medication histories and usually resulted in liver injury after 2-4 weeks.Drug-induced liver injury can be induced by many drugs,such as traditional Chinese medicine,antibiotics,anti-thyroid drugs and anti-tuberculosis drugs and etc.The main symptoms included abdominal pain,fatigue,anorexia,nausea,vomiting,jaundice.Liver function tests were characterized by a predominant rise in the serum transaminases,bilirubin and alkaline phosphatase.Most of the patients were recoverable after withdrawal,liver treatment and active supportive care,steroid therapy when necessary.[Conclusion]In the clinical work,we should focus on the side effects of the drugs to avoid liver injury.Once it occurred,the positive and effective treatment should be given.

关 键 词：药物/中毒 药物性肝损害 药物毒副作用 

分 类 号：R595.4[医药卫生—内科学]