药物性肝损伤临床特点及致病药物回顾性分析  

Retrospective analysis of clinical characteristics of liver injury induced by drugs and its causative agents

作　　者：李俊[1] 黄绍萍[1] 陆基华[1] 殷科珊[1] 樊贞瑜[1] 唐荣[1] 徐烈[1] 程计林[1] 

机构地区：[1]上海市(复旦大学附属)公共卫生临床中心消化科,上海201508

出　　处：《胃肠病学和肝病学杂志》2016年第2期164-167,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨药物性肝炎患者的致病药物和临床特征,评价可疑药物与疾病的相关性,提高临床医师对药物性肝炎的认识。方法回顾性总结2013年2月-2015年4月收治的198例药物性肝炎患者的临床资料,根据其用药种类、临床表现、实验室检查、发生药物性肝炎的时间及停药后的治疗效果进行综合分析。结果药物性肝炎发生在用药后4周内最多见(116/198,占58.59%)。诱发药物性肝炎的药物中,以中药(99/198,占50.00%)、抗结核药(48/198,占24.24%)、抗感染药(15/198,占7.58%)多见,其他导致肝损伤的药物还有解热镇痛药、抗肿瘤药、抗精神病药、降血脂药、降血压药、降血糖药、抗风湿药、抗真菌药、抗痛风药、胃药等(36/198,占18.18%)。临床表现以肝细胞损伤型最多(144/198,占72.73%),重度肝损伤占64.14%(127/198)。结论药物性肝损伤呈重度化趋势,尤其以中药比例居高,须警惕。Objective To analyze the drug-induced hepatitis and the clinical features of drug-induced hepatitis, and to explore the correlation between the suspected drugs and diseases. Methods One hundred and ninety-eight patients with drug-induced hepatitis were enrolled from Feb. 2013 to Apr. 2015. The clinical data were analyzed according to the kinds of the drugs, the clinical manifestation, the laboratory examination, the occurrence time of drug-induced hepatitis and the effect of drug discontinuance. Results Most drug-induced hepatitis occurred within 4 weeks after medication （116/198, 58.59% ）. Among the inducements of liver damage, traditional Chinese medicine （99/198, 50.00% ）, anti-tuberculosis drugs （48/198, 24.24% ）, and anti-infective drugs （ 15/198, 7.58% ） were more commonly. Others were antipyretic analgesics, antitumor drugs, antipsychotics, lipid-lowering agents, antihypertensive drugs, hypoglyce- mic drugs, anti-rheumatism medicine, antifungal drugs, anti-gout drugs, the stomach medicine, etc. （36/198, 18.18% ）. Most clinical manifestations were the liver cell damage type （144/198, 72.73% ）. Severe liver injury accounted for 64. 14% （1：27/198）. Conclusion Drug-induced liver injury presents a severe tendency. Traditional Chinese medicine is an important reason for it. The clinicians should increasingly attach more importance to it.

关 键 词：药物性肝炎 致病药物 临床特点 

分 类 号：R575[医药卫生—消化系统]