药物性肝衰竭的临床特点及诊治策略  

Clinical features of drug-induced liver failure and related diagnosis and treatment strategies

作　　者：赖荣陶[1] 谢青[1] LAI Rongtao;XIE Qing(Department of Infectious Diseases,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院感染科,上海200025

出　　处：《临床肝胆病杂志》2021年第11期2534-2538,共5页Journal of Clinical Hepatology

基　　金：国家自然科学基金项目(82070604,81770587,8197054);上海市卫生健康委员会科研面上项目(202040111);上海市临床重点专科(感染病学)(shslczdzk01103);十三五“科技部重大专项”(2017ZX10203201-008,2018ZX09201016-003-001,2017ZX10202202-005-004)。

摘　　要：药物性肝损伤(DILI)发生率逐年上升,其中药物相关的肝衰竭病情严重、治疗手段有限、病死率高,应引起临床医师的高度重视。对乙酰氨基酚(APAP)是西方国家急性肝衰竭(ALF)的最常见原因,除此之外,由于目前缺乏对宿主易感性和发病机制的深入了解,特异性DILI诱发的ALF患者早期不易被识别,自发恢复率低,预后更为凶险,已成为多个国家紧急肝移植的主要适应征。全面了解药物性肝衰竭的临床特征和预后,寻求新的可靠诊断方法和有效的治疗策略对降低药物相关肝衰竭的疾病负担至关重要。The incidence of drug-induced liver injury(DILI)has risen considerably in recent years.Drug-induced liver failure tends to have severe conditions,limited therapeutic strategy,and a high mortality rate and should thus be taken seriously by clinicians.N-acetyl-p-aminophenol is the most common cause of acute liver failure(ALF)in Western countries;for ALF associated with idiosyncratic DILI(iDILI),since there is little in-deep understanding of host susceptibility and pathogenesis,it is difficult to identify ALF caused by iDILI in the early stage,and due to a low rate of spontaneous recovery and poor prognosis,it has become a major indication for emergency liver transplantation in many countries.A comprehensive understanding of the clinical features and prognostic prediction of drug-induced liver failure and the search for new reliable diagnostic methods and effective treatment strategies are of vital importance in reducing the disease burden of drug-induced liver failure.

关 键 词：化学性与药物性肝损伤 肝功能衰竭 诊断 治疗学 

分 类 号：R575[医药卫生—消化系统]