中国老年人急性药物性肝损伤879例临床荟萃分析  

Acute drug-induced liver injury in 879 elderly Chinese： a meta-analysis

作　　者：张颖[1] 张赣生[1] 保志军[1] 于晓峰[1] 郑松柏[1] 

机构地区：[1]复旦大学附属华东医院消化科,上海200040

出　　处：《中华老年多器官疾病杂志》2013年第6期434-437,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的 探讨分析我国老年人急性药物性肝损伤的发病特点及诊治策略。方法 以“药物性肝损”或“药物性肝病”和“老年”为检索词，检索中文数据库，提取符合标准的临床资料进行总结和分析。结果 符合纳入标准的文献14篇，共879例老年急性药物性肝损伤患者，男583例，女296例。主要临床表现依次为消化道症状（45.41%）、黄疸（34.58%）、乏力（25.48%）、纳差（21.84%）等，无症状者占35.04%。临床分型以肝细胞型最为多见（57.40%）。有827例患者提供了用药信息，其中以抗生素（18.98%）、中草药（18.26%）、心血管类药物（17.90%）和抗肿瘤药物（11.61%）多见。774例患者提供了预后信息，临床治愈和好转率为89.41%。结论 正确认识和处理老年人急性药物性肝损伤，对改善患者预后，降低病死率具有重要而深远的意义。Objective To investigate the clinical features and treatment strategy of acute drug-induced liver injury （DILI） in elderly Chinese patients. Methods Databases of CBM, VIP, Wanfang and CNKI were searched by retrieving from construction to 2011 with the key words “drug-induced liver injury or drug-induced liver disease, and elderly”. Data from retrieved literatures were summarized and analyzed by SPSS 14.0 software. Results There were 14 studies meeting the inclusion criteria, which included 879 elderly patients with acute DILI （583 males and 296 females）. The main clinical manifestations were digestive symptoms （45.41%）, jaundice （34.58%）, fatigue （25.48%）, and anorexia （21.84%）, and so on. While, 308 patients （35.04%） were asymptomatic. Clinical classification indicated that hepatocellular type accounted for the largest proportion of acute DILI in the elderly （57.40%）. The most common drugs causing acute DILI were antimicrobial agents （18.98%）, Chinese traditional medicine （18.26%）, cardiovascular drugs （17.90%） and antineoplastics （11.61%） in order. As for the prognosis, 692 of 774 cases （89.41%） were recorded being clinically cured or improved. Conclusion It is of great significance to diagnose and treat acute DILI early and properly, especially for the elderly patients so as to improve the prognosis and decrease mortality.

关 键 词：老年人 药物性肝损伤 药物副反应 

分 类 号：R592[医药卫生—老年医学] R575[医药卫生—内科学]