某院急性白血病患者药源性肝损伤临床治疗的回顾性分析  

Retrospective analysis on the treatment of drug induced liver injury in acute leukemia patients

作　　者：张倩茹 卢颖 张婉婷 杨艳 Zhang Qianru;Lu Ying;Zhang Wanting;Yang Yan(Department of Pharmacy,Affiliated Hospital of Zunyi Medical University,Zunyi Guizhou 563003,China;Guizhou Engineering Research Center of Industrial Key-technology for Dendrobium Nobile,Zunyi Guizhou 563006,China)

机构地区：[1]遵义医科大学附属医院药剂科,贵州遵义563003 [2]遵义医科大学贵州省高等学校金钗石斛产业发展关键技术工程研究中心,贵州遵义563006

出　　处：《遵义医科大学学报》2024年第4期401-407,共7页Journal of Zunyi Medical University

基　　金：贵州省科技厅基础项目[NO:黔科合基础-ZK(2023)一般509];贵州省卫健委基金资助项目(NO:gzwkj2022-223)。

摘　　要：目的 对急性白血病(AL)患者药源性肝损伤(DILI)治疗进行回顾性分析,为临床用药提供相关依据。方法 收集某院2015年1月至2020年12月共6年间收治发生DILI的AL住院患者的临床资料,统计并分析患者的年龄、性别、肝脏功能指标、DILI严重程度、DILI类型、保肝药物、转归等信息,采用χ^(2)检验分析DILI患者转归的影响因素。结果 共84例患者发生DILI并接受治疗,总有效率为72%。DILI类型和药物用法是影响转归的2个重要因素(P<0.05)。肝脏生化异常型是DILI主要类型(80.67%),但该类型的患者预后较差,总有效率仅为68.2%。共6类13种药物被用于DILI治疗,临床治疗以单次用药(62%)和二联用药(34%)为主,药物用法与患者转归显著相关,二联用药可明显改善患者预后(P<0.05)。还原型谷胱甘肽(45.0%)、异甘草酸镁(27.10%)、门冬氨酸鸟氨酸(14.02%)是临床使用最多的药物。结论 多数AL患者的DILI预后较好,但仍应制订合理方案进行对症治疗以提高有效率,药物用法是影响患者转归的重要因素,需保持重点关注。Objective This research aims to explore the influential factors for drug-induced liver injury(DILI) in acute leukemia(AL) patients through retrospective analysis.Methods The information of AL patients with DILI hospitalized in a hospital from January 2015 to December 2020 were collected.Chi-square test was utilized to identify influential factors(age,gender,type of AL,state of DILI,type of DILI,indicators of liver function,hepatoprotective drugs,outcome) for DILI treatment of AL patients.Chi-square test was utilized for the correlation analysis.Results A total of 927 AL patients were enrolled,of which 84 patients had DILI and received medication with the effective rate of 72%.The influential factors that significantly correlated with patient outcomes were DILI types and drug usages,respectively(P<0.05).Abnormal liver function was identified as the major type of DILI(80.67%) but with less effective ratio(68.2%).A total of 13 hepatoprotective drugs were classified into 6 categories and used in the DILI treatment.The medical therapy alone is the most common type of drug usages(62%).The mostly common drugs were reduced glutathione(45.0%),magnesium isoglycyrrhizinate(27.10%),and ornithine aspartate(27.10%).Conclusion Based on the data of the current study,DILI has good prognosis in most AL hospitalized patients.Evidence-based treatment and combinational usages of hepatoprotective drugs play a significant role in the treatment of DILI.A special attention should be still paid on the existence of clinical abuse of hepatoprotective drugs.

关 键 词：急性白血病 药物性肝损伤 回顾性分析 保肝药物 

分 类 号：R975.5[医药卫生—药品]