白鲜皮导致药物性肝损伤的病理学及血清酶学改变  

The serum enzyme and pathological characteristics of Cortex Dictamni-induced liver injury

作　　者：刘宇翰 周雨燕 孙慧敏 孙文才 于鲁 姜亦洲 原林皓 冯骥良 

机构地区：[1]首都医科大学附属北京佑安医院临床病理中心,北京100069 [2]解放军第二五一医院临检中心,河北张家口075000 [3]解放军第二五一医院肾病中医科,河北张家口075000

出　　处：《中国当代医药》2017年第26期7-11,共5页China Modern Medicine

基　　金：北京市中医药科技项目(JJ2014-09)

摘　　要：目的分析白鲜皮所致药物性肝损伤患者的病理学及血清酶学特点。方法回顾性研究2014年1月~2016年1月解放军第二五一医院和首都医科大学附属北京佑安医院收治的20例白鲜皮导致药物性肝损伤患者的临床和病理资料。20例白鲜皮导致药物性肝损伤患者作为试验组,并以40例急性甲型肝炎(甲肝组)、40例急性乙型肝炎(乙肝组)和40例酒精性肝炎(酒精肝组)患者的临床和病理资料作为疾病对照组,以同期在解放军第二五一医院进行体检的20例健康患者作为正常对照组。比较各组的ALT和AST水平。结果在20例白鲜皮导致肝损伤患者的肝穿刺活检中,主要病理学表现为急性小叶性炎,同时包括肝细胞的坏死和变性。随着治疗进程的推进,试验组和其他对照组患者的ALT和AST水平逐渐降低。在整个病程中,试验组患者的ALT、AST水平与正常对照组比较,差异均有统计学意义(P<0.01)。而在病程中后期,试验组患者的AST水平与甲肝组、乙肝组比较,差异均有统计学意义(P<0.05)。结论结合肝穿刺活检和血清酶学分析,可以对白鲜皮导致的药物性肝损伤进行早期诊断和鉴别诊断,并对患者的预后进行评估。Objective To investigate the characteristics of the serum enzyme and histomorphology of patients with liver injury induced by Cortex Dictamni.Methods Clinical and pathological data of 20 patients with Cortex Dictamni-induced liver injury who treated in the 251^（st） Hospital of PLA and Beijing You′ an Hospital,Capital Medical University from January 2014 to January 2016 were retrospectively studied. 20 patients with Cortex Dictamni-induced liver injury were as test group,40 patients with acute HAV hepatitis（HAV group）,40 patients with acute HBV hepatitis（HBV group） and 40 patients with alcoholic hepatitis（alcoholic hepatitis group） were enrolled as disease control groups,the serum enzyme information of 20 healthy people examined at the 251^st Hospital of PLA in the same period were applied as normal control.The levels of ALT and AST in each group were compared.Results Liver biopsy in 20 cases of liver injury induced by Cortex Dictamni showed that the main pathological manifestations were acute intra-lobular inflammation,including hepatocyte necrosis and degeneration were the major pathological changes.With the treatment after admission,the ALT and AST levels of the patients in test group and other disease control groups were decreased gradually.In the whole course of the treatment process,the ALT and AST levels of the patients in the test group were compared with the normal control group,and the differences were statistically significant（P〈0.01）.However,in the middle and late of the course of the treatment process,the AST level of the patients in test group were compared with the HAV and HBV group,the differences were statistically significant（P〈0.05）.Conclusion Combined with liver biopsy and serum enzyme analysis can be applicable strategy in diagnosis,differential d iagnosis of Cortex Dictamni-induced liver injury,as well as in evaluation the prognosis of these patients.

关 键 词：药物性肝损伤 白鲜皮 血清酶学 病理 诊断 

分 类 号：R575[医药卫生—消化系统]