住院患者药物性肝病的危险因素和可疑药物分析  

Analysis of risk factors and suspected drugs of drug-induced liver disease in inpatients population

作　　者：姜慧芳[1] 程能能[1] 杜文民[2] 陈斌艳[1] 

机构地区：[1]复旦大学药学院药理学教研室,上海201203 [2]上海市药品不良反应监测中心,上海200233

出　　处：《中国临床药学杂志》2011年第5期282-285,共4页Chinese Journal of Clinical Pharmacy

摘　　要：目的探讨药物性肝病在住院患者人群中的发生率、危险因素和可疑药物。方法基于上海市医院住院患者用药数据库中拥有2次及以上ALT记录的患者人群,以用药后ALT>60 U·L^(-1)为药物性肝病的评价标准,采用逐步Logistic回归方法分析年龄、性别、服药种类、住院时间和基线ALT值对药物性肝病发生率的影响,并计算引起药物性肝病的可疑药物的似然比。结果 :纳入研究的3030例患者中药物性肝病有171例,占5.61%。服药种类是其危险因素。药物性肝病的可疑药物涉及各个类别的药物,以中药出现的频次最高,其次为主要抗菌药物。有220种可疑药物可能与药物性肝病有关,其中磺胺甲(?)唑、氯胺酮等似然比较高。结论住院患者在合并使用多种药物和应用磺胺甲(?)唑等具有肝毒性药物时应加强肝功能监测,以避免药物性肝病的发生。AIM To study the incidence rate, risk factors and suspected drugs of drug-induced liver disease in inpatients population. METHODS Based on Shanghai inpatients drug utilization database we concluded in our study those patients whose alanine aminotransferase value was twice recorded and set the alanine aminotransferase value over 60 U· L^-1 as the assess standard for drug-induced liver disease. We used Logistic regression analysis method to analyze the effects of age, sex, drug, length of hospital stay and baseline alanine aminotransferase value on drug-induced liver disease, and calculated the likelihood of suspected drug in inducing liver disease. RESULTS A total of 3 030 inpatients fell into the selective criteria, 171 （5.61 % ）cases was diagnosed as drug-induced liver disease. Medication type was a risk factor. The suspected drugs involved all kinds of drugs, and among these involved drugs the Chinese traditional medicine had the highest cited frequency, the antibacterial agents the second. A total of 220 drugs were suspected as liver disease inducing drug, sulfamethoxazole and ketamine had the higher likelihood. CONCLUSION To avoid drug-induced liver disease, medication should be attached to liver function monitoring when inpatients are applied with multi - drugs or drug with liver toxicity.

关 键 词：药物性肝病 危险因素 可疑药物 似然比 

分 类 号：R595.3[医药卫生—内科学]