三唑类抗真菌药物致肝损伤的研究进展  

Research advances of liver injury induced by triazole antifungal agents

作　　者：向丽萍 龚卫静 刘婉玉 黄建耿[3] 斯陆勤[3] 张玉[1,2] 伍三兰 XIANG Li-ping;GONG Wei-jing;LIU Wan-yu;HUANG Jian-geng;SI Lu-qin;ZHANG Yu;WU San-lan(Department of Pharmacy,Affiliated Union Hospital,Tongji Medical College,Huazhong University of Science&Technology,Hubei Wuhan 430022,China;Hubei Province Clinical Research Center for Precision Medicine for Critical Illness,Hubei Wuhan 430022,China;School of Pharmacy,Tongji Medical College,Huazhong University of Science&Technology,Hubei Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属协和医院药学部,湖北武汉430022 [2]湖北省重大疾病精准用药临床医学研究中心,湖北武汉430022 [3]华中科技大学同济医学院药学院,湖北武汉430030

出　　处：《中国医院药学杂志》2021年第14期1475-1480,共6页Chinese Journal of Hospital Pharmacy

基　　金：国家自然科学基金项目(编号:81803619);湖北省卫生计生科研基金资助项目(编号:WJ2017M118)。

摘　　要：药物性肝损伤是临床常见的药源性疾病之一,也是药物临床试验失败和撤市的主要原因之一。三唑类抗真菌药物是治疗侵袭性真菌感染的主要药物,对多种临床常见真菌具有良好的抗菌活性,临床应用广泛。但随着三唑类抗真菌药物临床应用的日益增多,其肝损伤不良反应的报道也越来越多,给该类药物的临床应用带来一定挑战。三唑类抗真菌药物致肝损伤的影响因素包括药物浓度、年龄、基因多态性、炎症等,发生机制包括氧化应激、胆汁淤积、调节细胞色素P450的表达及脂质代谢异常等多个方面。本文将对三唑类抗真菌药物致肝损伤的临床特点、影响因素及发生机制的研究进展进行综述,以期为该类药物肝损伤的深入研究及临床安全合理应用提供参考。As one of the most common drug-induced diseases,drug-induced liver injury is also a major cause for failed clinical trials and drug withdrawals.Triazole antifungal agents are the major drugs for invasive fungal infections.They have excellent antibacterial activities against a variety of common clinical fungi.However,with wider clinical applications of triazole antifungal agents,frequent reports of adverse reactions of liver injury have presented some challenges to the clinical application of these drugs.The influencing factors of liver injury induced by triazole antifungal agents include drug concentration,age,gene polymorphism and inflammation.The etiological factors include oxidative stress,cholestasis,regulation of cytochrome P450 expression and abnormal lipid metabolism.This review summarized the latest advances of clinical characteristics,influencing factors and pathogenesis of liver injury induced by triazole antifungal agents.The goal was to provide rationales for more in-depth studies of liver injury and clinical rational application of triazole antifungal agents.

关 键 词：三唑类抗真菌药物 药物性肝损伤 影响因素 机制 

分 类 号：R969.3[医药卫生—药理学]