198例抗精神失常药物致肝损害回顾性分析  

Retrospective Analysis of 198 Cases of Liver Injury Caused by Antipsychotic Drugs

作　　者：巢楠 陈颖 王莹 吴晓燕 汤露 李清 瞿发林 CHAO Nan;CHEN Ying;WANG Ying;WU Xiao-yan;TANG Lu;LI Qing;QU Fa-lin(The 904th Hospital of Joint Logistic Support Force of PLA,Changzhou 213003,China)

机构地区：[1]联勤保障部队第九○四医院,江苏常州213003

出　　处：《解放军药学学报》2023年第1期57-59,共3页Pharmaceutical Journal of Chinese People's Liberation Army

基　　金：全军医药卫生科研基金课题,No14ZX04。

摘　　要：目的分析某医院抗精神失常药物致药物性肝损害的发生规律及特点,探讨发生机制,以减少临床药物性肝损害的发生,促进合理用药。方法对某医院2020年1月-2021年12月共198例抗精神失常药物致药物性肝损害病例,根据患者的性别、年龄、涉及药物、发生时间、临床表现、实验室数据、治疗与转归,采用SPSS17.0软件进行统计分析,分析其临床特点和用药情况。结果198例药物性肝损害病例中男性152例(76.77%),女性46例(23.23%),男性与女性比较,有统计学显著差异(P<0.001);平均年龄(32.27±13.04)岁;涉及4个药品种类、14种抗精神失常药物;患者用药后出现药物性肝损害时间最短为6 d,最长为6个月,平均为(38.31±27.57)d;101例(51.01%)患者无临床症状,97例(48.99%)患者有临床症状,其中乏力、食欲减退、小便偏黄居多;实验室指标示丙氨酸转氨酶升高108例(54.55%),天冬氨酸转氨酶升高74例(37.37%),谷氨酰转肽酶升高24例(12.12%),总胆红素升高6例(8.08%),直接胆红素升高10例(5.05%);经治疗后肝功能恢复平均为(29.59±32.28)d,痊愈/好转率为90.40%。结论抗精神失常药物所致药物性肝损害多数为可逆的,预后良好;中年男性可能为药物性肝损害的高危人群。临床应重视肝功能监测,确保临床安全合理用药。Objective To analyze the regularity and characteristics of liver injury caused by antipsychotic drugs in a hospital,and to explore the mechanism for drug-induced liver injury in order to reduce the incidence of drug-induced liver injury and promote rational drug use.Methods A total of 198 cases of liver injury caused by antipsychotic drugs in a hospital between 2020 and 2021 were collected.The gender and age of patients,medications,time of onset,clinical manifestations,laboratory data,treatments and outcomes of the patients,and drugs used were statistically analyzed using SPSS17.0 software.Results There were 152 males(76.77%)and 46 females(23.23%)among the 198 cases.The incidence of drug-induced liver injury was significantly different between the two groups(P<0.001).The mean age was(32.27±13.04)years.The drugs that caused liver injury involved 4 categories that included 14 types of drugs.The interval between primary medication to onset ranged from 6 days to 6 months,with an average of(38.31±27.57)d.Ninety-seven of these cases(48.99%)showed clinical symptoms,including fatigue,anorexia and yellow urine,while 101 cases(51.01%)did not.Liver function indicators showed that alanine aminotransferase increased in 108 cases(54.55%),aspartate aminotransferase in 74 cases(37.37%),glutamyl transpeptidase in 24 cases(12.12%),total bilirubin in 6 cases(8.08%),and direct bilirubin in 10 cases(5.05%).After treatment,the recovery time of liver function averaged(29.59±32.28)d,and the recovery/improvement rate was 90.40%.Conclusion Middle-aged males may be at high risk of drug-induced liver injury.Most of the liver injuries induced by antipsychotic drugs are reversible and have a good prognosis.Clinicians should monitor liver function of patients for early detection of abnormalities and quick treatment to ensure safe and rational drug use.

关 键 词：药物性肝损害 抗精神病药 药品不良反应 

分 类 号：R971.4[医药卫生—药品]