短期应用改善病情抗风湿药治疗类风湿关节炎出现肝功能异常的临床特点  

Clinical characteristics of abnormal liver function in short-term application of disease-modifying anti-rheumatic drugs in the treatment of rheumatoid arthritis

作　　者：张颖[1] 王俊祥[1] ZHANG Ying;WANG Jun-xiang(Department of Rheumatology and Immunology,Third Hospital of Hebei Medical University,Hebei Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院风湿免疫科,河北石家庄050051

出　　处：《中国医院药学杂志》2022年第7期736-739,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:观察短期应用改善病情抗风湿药(disease-modifying antirheumatic drug, DMARD)治疗类风湿关节炎致肝功能异常发生率及其特点。方法:分析2016年6月至2019年6月初诊首次应用DMARD治疗的类风湿关节炎患者472例,观察患者2周后肝功能异常的发生情况以及临床特点。结果:472例患者完成2周治疗后发生肝功能异常54例(11.44%);应用DMARD单药肝功能异常发生率为12.06%(34/282),其中氨甲蝶呤发生率最高,为22.73%(10/44);DMARD联合用药肝功能异常发生率为10.53%(20/190),氨甲蝶呤联用柳氮磺吡啶发生率最高,为22.22%(2/9);发生肝功能异常者的血沉高于无肝功能异常者(P=0.016);应用氨甲蝶呤发生肝功能异常的风险最大(OR=1.902),羟氯喹可减少肝功能异常的发生(OR=0.325)。结论:应用DMARD治疗类风湿关节炎短期内即可导致肝功能异常,可能与个体敏感性及药物选择有关。OBJECTIVE To observe the incidence and characteristics of abnormal liver function in patients with rheumatoid arthritis(RA) treated with short-term disease-modifying antirheumatic drugs(DMARD).METHODS Totally 472 newly diagnosed RA patients treated with DMARD for the first time from June 2016 to June 2019 were analyzed to observe the occurrence and clinical characteristics of abnormal liver function after 2 weeks.RESULTS In the 472 patients, abnormal liver function was detected out in 54 cases(11.44%) after 2 weeks of treatment. The incidence of abnormal liver function was 12.06%(34/282) with DMARD monotherapy, and methotrexate had the highest incidence of 22.73%(10/44). The incidence of abnormal liver function was 10.53%(20/190) with DMARD combination therapy, and MTX+SSZ had the highest rate of 22.22%(2/9). Erythrocyte sedimentation rate in patients with abnormal liver function were higher than that in those with normal liver function(P=0.016). The risk of liver dysfunction with MTX was the highest(OR=1.902), and hydroxychloroquine could reduce the occurrence of abnormal liver function(OR=0.325).CONCLUSION The short-term application of DMARD for RA can lead to liver injury, which may be related to individual sensitivity and drug selection.

关 键 词：改善病情抗风湿药 类风湿关节炎 肝损伤 

分 类 号：R593.22[医药卫生—内科学]