药物淋巴细胞刺激试验在药物性肝损伤诊断中的意义  

The efficacy of drug lymphocyte stimulation test in diagnosis of drug-induced liver injury

作　　者：孙双双[1] 傅青春 杨峻[3] 程明亮 王晓今 倪鎏达 施莉琴 王琳 夏凡 陈成伟 

机构地区：[1]贵阳医学院,550004 [2]上海南京军区肝病研究中心 [3]解放军第八五医院检验科 [4]南京军区结核病中心

出　　处：《肝脏》2015年第3期215-217,共3页Chinese Hepatology

基　　金：中国肝炎防治基金会天晴肝病研究基金(TQGB2011005)

摘　　要：目的评估药物淋巴细胞刺激试验(drug lymphocyte stimulation test,DLST)对药物性肝损伤(Drug induced liver injury,DILI)临床诊断的意义。方法对84例临床诊断为DILI、17例疑诊、17例有服药史的非DILI患者行DLST检测,结合其人口学资料、临床分型、临床生化指标等进行非随机对照的回顾性分析,进一步评价DLST在临床的应用价值。结果 101例临床诊断或疑诊DILI患者中,共36例DLST阳性,DLST特异度为98.6%,在所有DILI患者中(包括过敏特异质和遗传特异质)敏感度35.6%。DLST阳性与RUCAM有较好的相关性(P=0.015)。结论药物淋巴细胞刺激试验对药物导致的肝损伤具有较高的诊断特异性,结合RUCAM评分可提高DILI的诊断标准性。Objective To evaluate the efficacy of drug lymphocyte stimulation test （DLST）in the clinical diagnosis of drug-induced liver injury （DILI）.Methods Eigty-four DILI patients,17 suspected DILI patients and17 non-DILI patients were enrolled,and retrospectively analyzed with case-controlled method according to demographic data,clinical classification,clinical biochemical indicator,and so on,to further clarify the value of DLST in clinical practice.Results Among 101 patients with clinical diagnosed or suspected DILI patients,DLST in 36 cases was positive,of which specificity was 98.6% and sensitivity was 35.6%.DLST positive and roussel uclaf causality assessment method （RUCAM）score showed a fairly good correlation （P = 0.015 ）in diagnosing DILI.Conclusion DLST has a high specificity for DILI diagnosis,while its sensitivity is poor.Combined with RUCAM score,DLST might improve the diagnostic standard of DILI.

关 键 词：药物性肝损伤(DILI) 药物淋巴细胞刺激试验(DLST) 诊断 

分 类 号：R575[医药卫生—消化系统]