141例药物性肝炎患者的临床分析  

Clinical features of 141 patients with drug-induced hepatitis

作　　者：赵冬[1] 李洪璐[1] 刁振瀛[1] 李常青[1] 

机构地区：[1]首都医科大学附属北京地坛医院,北京100015

出　　处：《中华实验和临床感染病杂志（电子版）》2013年第2期86-89,共4页Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)

基　　金：国家自然科学基金(No.30600524)

摘　　要：目的分析141例药物性肝炎患者的临床资料,为该类患者的临床安全用药提供依据。方法回顾性分析141例药物性肝炎患者的临床体征、致病药物种类、药物引起肝损害的时间以及各型药物性肝炎的特点。结果全身各系统用药均可引起肝损害,其中最常见的是中草药(48/141,占34.04%)和抗结核药(21/141,占14.89%)。HBsAg阳性者更易发生重症药物性肝炎(χ2=44.76,P<0.05)。肝脏组织学病理诊断对药物性肝炎的诊断及鉴别诊断具有重要作用。结论了解药物性肝炎的影响因素,包括药物种类、用药时间、联合用药、是否合并HBV感染及HBV载量高低等相关因素,有助于提高临床医师对药物性肝炎的鉴别诊断,提高临床用药的安全性。Objective To analyze the clinical features of 141 cases with drug-induced hepatitis for safety medication. Methods Total of 141 patients with drug-induced hepatitis were enrolled, and clinical manifestations, pathogenic types of drugs, the emergence time of drug-induced liver injury and the characteristics in various types of drug-induced hepatitis were analyzed, retrospectively. Results All drugs could cause liver damage; the most common were Chinese medicine （48/141, 34.04%） and anti-TB drugs （21/141, 14.89%）. Patients with HBsAg positive and （or） high viral load of HBV DNA might be more likely to occur severe drug-induced hepatitis （x2 = 44.76, P 〈 0.05）. Pathological diagnosis played an important role in drug-induced hepatitis. Conclusions The important impact factors of drug-induced hepatitis included types of drugs, time of medication, combination therapy, the complication of HBV infection, high level of HBV viral load and other relevant factors, which could improve diagnosis of drug-induced hepatitis and safe medication.

关 键 词：药物性肝炎 病因 临床特点 

分 类 号：R595.3[医药卫生—内科学]