药物性肝损伤的临床热点问题探讨  

Focus on drug-induced liver injury

作　　者：董旭旸[1] 周新民[1] 

机构地区：[1]第四军医大学西京消化病医院消化内科,西安710032

出　　处：《中华消化病与影像杂志（电子版）》2015年第4期1-3,共3页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：随着处方药及中草药的应用增多,药物性肝损伤越来越受到重视。中草药和抗结核药物是目前我国药物性肝损伤的主要原因。药物诱导的自身免疫性肝炎与免疫介导的药物性肝损伤较难鉴别。肝脏组织学特征及对激素治疗的反应有助于其鉴别诊断。糖皮质激素对于胆汁淤积表现明显、免疫反应强烈的药物性肝损伤具有治疗作用,应注意早期应用,把握好适应证。人工肝支持系统对重症药物性肝损伤具有较好的疗效,根据具体临床病例,可采用多种模式联合,进行个体化治疗。With a widely using of prescription medication and herbal supplement, it has been increasingly pay attention to drug-induced liver injury （DILI）. Herbal remedies and tuberculostatics are the most common causes of DILI in China. To differentiate between true autoimmune hepatitis triggered by drugs （DI-AIH） and immune mediated DILl still remains a challenge. Histological features and the response to corticosteroid therapy support the diagnosis. Glucocorticoid therapy may be an effective treatment for DILl with obvious cholestasis or strong immune response. Early application should be paid attention to, and indications should be strictly controlled. For severe DILI, the artificial liver support system has been proved to be valuable. Individualized therapy and comprehensive patterns should be advocated according to the specific clinical cases.

关 键 词：药物性肝损伤 肝炎 自身免疫性 糖皮质激素类 人工器官 

分 类 号：R595.3[医药卫生—内科学]