药物性肝损伤临床风险信号发现:挑战与进展  

Detection of the risk signals of drug-induced liver injury:Challenges and advances

作　　者：景婧 何婷婷 王睿林 张帆 牛明 郭玉明 朱云 肖小河 王伽伯 JING Jing;HE Tingting;WANG Ruilin(Treatment and Research Center of Integration of Traditional and Western Medicine,The Fifth Medical Center of Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第五医学中心中西医结合诊疗与研究中心,北京100039 [2]解放军总医院第五医学中心全军中医药研究所,北京100039 [3]湖南中医药大学第一中医临床学院,长沙410208

出　　处：《临床肝胆病杂志》2020年第3期491-496,共6页Journal of Clinical Hepatology

基　　金：国家自然科学基金重点项目(81630100);国家自然科学基金创新群体项目(81721002);国家“重大新药创制”科技重大专项课题(2015ZX09501-004-001-008);国家公益性行业专项课题(201507004-04);国家自然科学基金资助项目(81673806);军委后勤保障部卫生局应用基础研究项目(17BJZ53)。

摘　　要：早期发现药物性肝损伤(DILI)临床风险信号,并对其进行有效监测,对临床上DILI预防和管理极为重要。但是,由于当前DILI临床风险信号还存在灵敏度不足、专属性不强等问题,为风险信号的发现与监测带来了巨大挑战,同时也给建立DILI风险防控对策带来了难题。分析了DILI临床风险信号发现所面临的挑战,梳理了基于临床常用指标的风险信号对DILI早期识别、预测和预警的适用性和局限性,提出基于特异生物标志物的DILI临床风险信号发现与监测模式,并阐述其潜在的临床应用价值,以期为针对性制定DILI风险防控对策提供科学参考。Early detection and effective monitoring of the risk signals of drug-induced liver injury(DILI)are of great importance in the prevention and management of DILI in clinical practice.However,the lack of high sensitivity and strong specificity in the detection of risk signals brings great challenges to the identification and monitoring of risk signals and causes difficulties in establishing the strategies for the prevention and control of DILI.This article analyzes the challenges in the identification of DILI risk signals,summarizes the applicability and limitations of risk signals based on commonly used indices in early recognition,prediction,and early warning of DILI,proposes an identification and monitoring model for DILI risk signals based on specific biomarkers,and elaborates on their potential clinical values,so as to provide a scientific basis for developing targeted strategies for the prevention and control of the risk of DILI.

关 键 词：药物性肝损伤 生物学标记 诊断 预后 疾病易感性 

分 类 号：R575[医药卫生—消化系统]