某院药物性肝损伤治疗与诊疗指南依从性及预后的4年临床数据分析  

A 4-year Clinical Data Analysis of Treatment Compliance with Guidelines for Diagnosis and Prognosis of Drug-Induced Liver Injury in a Hospital

作　　者：马晓 林红[2] 杨建彬[1] 杨坤[2] 程虹[2] 吴东方[2] MA Xiao;LIN Hong;YANG Jian-bin;YANG Kun;CHENG Hong;WU Dong-fang(Department of Pharmacy,Xingtai People's Hospital,Xingtai 054031,China;Department of Pharmacy,Zhongnan Hospital,Wuhan University,Wuhan 430071,China)

机构地区：[1]邢台市人民医院药剂科,河北邢台054031 [2]武汉大学中南医院药学部,武汉430071

出　　处：《中国药学杂志》2021年第20期1694-1698,共5页Chinese Pharmaceutical Journal

摘　　要：目的探讨药物性肝损伤(drug-induced liver injury,DILI)的治疗方法和预后影响因素,为DILI临床治疗提供相关依据。方法采用回顾性分析方法,收集某院2016年1月至2019年12月期间收治的202例DILI病例,统计患者的年龄、性别、基础疾病、可疑药物、谷丙转氨酶(alanine aminotransferase,ALT)、谷草转氨酶(aspartate aminotransferase,AST)、碱性磷酸酶(alkaline phosphatase,ALP)、总胆红素(total bilirubin,TBiL)、国际标准化比值(international normalized ratio,INR)及治疗、转归等情况。结果绝大多数患者预后较好,好转率81.2%;85.2%的患者联用2种以上保肝药物治疗;胆汁淤积型DILI比肝细胞损伤型、混合型预后较差;急性DILI比慢性DILI预后好;疗程较短或存在肝脏基础疾病的患者预后较差。结论DILI多数情况下预后较好,临床上存在保肝药物滥用的情况,应当引起格外关注。OBJECTIVE To explore the therapeutic methods and prognostic factors of drug-induced liver injury(DILI),thus to provide reference for clinical treatment of drug-induced liver injury.METHODS A retrospective analysis was conducted to collect 202 cases of drug-induced liver injury admitted between January 2016 and December 2019 in one tertiary hospital.Information on the patient's age,sex,basic diseases,suspicious drugs,cereal third transaminase(ALT),aspertate aminotransferase(AST)and alkaline phosphatase(ALP),total bilirubin(TBiL)and the ratio(INR)and international standardization treatment,outcome,and so on was collected and analyzed.RESULTS The vast majority of patients had a good prognosis,with an improvement rate of 81.2%.85.2%of patients were treated with two or more liver-protecting drugs.Cholestatic DILI had worse prognosis than hepatocyte injury type or mixed type.Acute DILI had better prognosis than chronic DILI.Patients with short course of treatment or liver-based diseases had poor prognosis.CONCLUSION Drug-induced liver injury has good prognosis in most cases,and the existence of clinical abuse of liver-protecting drugs should arouse special attention.

关 键 词：药物性肝损伤 治疗 转归 影响因素 

分 类 号：R969.3[医药卫生—药理学] R575[医药卫生—药学]