近10年药物性肝损伤患者的特点及变化趋势  

Characteristics and trends of patients with drug-induced liver injury during the last ten years in China :a single-center experience

作　　者：滕光菊[1] 李保森[1] 赵军[1] 张伟[1] 常彬霞[1] 孙颖[1] 黄昂[1] 邹正升[1] 

机构地区：[1]北京解放军第三○二医院非感染性肝病诊疗中心,100039

出　　处：《肝脏》2014年第5期329-331,共3页Chinese Hepatology

基　　金：302医院立项课题(YNKT2013012)

摘　　要：目的了解近10年来药物性肝损伤(drug-induced liver injury,DILI)的疾病特点及变化趋势。方法回顾分析解放军第302医院2002年1月至2011年12月间明确诊断为DILI的3135例患者资料,观察患者的疾病特点及变化趋势。结果急性DILI 2278例,占72.7%;慢性DILI 473例,占15.1%;药物性肝硬化236例,占7.5%;药物性肝功能衰竭148例,占4.7%。住院DILI患者占总的住院肝病患者的比例,从2002年的1.39%上升至2006年的2.31%,2011年上升至3.17%,10年间上升约2.3倍。3135例DILI患者中,男女之比为1∶1.24,差异有统计学意义(P<0.01)。药物性肝硬化患者平均年龄为55岁;药物性肝衰竭患者平均年龄为41.01岁,差异有统计学意义(P<0.01)。患者的分布以华北地区最多,占35.1%,其次为华中地区,占22.6%,北京和东北地区均为13.1%。急性和慢性DILI预后好,治愈好转率分别为91.3%及88.8%,药物性肝衰竭患者预后较差,治愈好转率为56.1%,病死率为9.4%,差异有统计学意义(P<0.01)。结论 DILI患者占总的住院肝病患者的比例不断上升,10年间上升2.3倍。临床DILI患者中急性DILI占多数,要重视DILI的早期诊断。药物性肝衰竭患者预后差,需重视DILI的规范治疗。Objective To investigate the characteristics and trends of patients with drug-induced liver injury （DILI）in China during the last ten years.Methods The characteristics and trends of 3135 patients with DILI treated in our hospital from January 2002 to December 2011 were retrospectively analyzed.Characteristics and trends of those patients were invetigated.Results According to clinical classification of DILI,among the 3135 patients,2278 （52.2%） patients were acute DILI,473 （15.1 %）patients were chronic DILI,236（7.5%）patients were drug-induced cirrhosis, and 148 （4.7%）patients were drug-induced liver failure, respectively. The trends of DILI included： （1 ） The hospitalization rate of kept growing,from 1 .39% in 2006 to 2.31 % in 2002,then rising to 3.17% in 2011 ,increased by about 2.3 times over the last ten years;（2）Among all the patients with DILI,ration of male/female was 1 ∶1 .24,the difference was statistically significant（P 〈0.01 ）;（3）For the patients with drug-induced cirrhosis,average age was 55 years old,while the average age of patients with drug-induced liver failure was 41 .01 years old,the difference was statistically significant （P 〈0.01 ）;（4）Patients distributed mostly in North China accounting for 35.1 %,followed by the central region,accounting for 22.6%.Beijing and the northeast area had the same distributions,each accounting for 13.1 %;（5）For acute and chronic DILI patients,the cure and improvement rates were 91 .3% and 88.8%,respectively. However,the prognosis of patients with liver failure drugs was poor with a 56.1 % cure and improvement rate and a 9.4% mortality,the difference was statistically significant （P 〈0.01）.Conclusion The proportion of patients with DILI in total hospitalization of patients with liver disease was rising and increased 2.3 times over the last ten years.As patients with acute DILI accounted for the majority of DILI,attention should be paid to the early diagnosis of DILI.Besides, importance needs to be attache

关 键 词：药物性肝损伤 药物性肝衰竭 回顾分析 

分 类 号：R575[医药卫生—消化系统]