摘要
目的分析比较我国药物性肝损害常用的两种国际诊断标准诊断的准确性。方法采用回顾性调查方法，总结分析引起药物性肝损害常用药物的种类。用Danan的药物性肝损害相关评价标准与Mafia评分标准，对230例药物性肝损害患者进行重新诊断，比较这两种诊断方法的差异。结果230例患者中引起药物性肝损害的常用药物依次为：中药类、抗生素、解热镇痛类、抗结核药、心血管类、保健药、精神类药、皮肤病类、降糖药等。230例患者以Danan的药物性肝损害相关评价进行诊断，有149例（64．8％）为药物引起的肝损害，不能确定的有71例（30．9％），非药物引起的肝损害有10例（4．3％）；以Maria评分标准进行诊断，确定为药物性肝损害的无一例患者，可能性大的有55例（23．9％），不能确定、仅仅为可能的126例（54．8％），可能性小的有33例（14．3％），可除外药物性肝损害的有16例（7．0％）。结论Danan的药物性肝损害相关评价标准与临床诊断符合率比Maria评分标准高，但还需进行改进修正。
Objective To compare and analyze the accuracy of two diagnostic criteria of druginduced liver injuries. Methods 230 cases of drug-induced liver injury diagnosed cfinically in the 302 hospital of PLA were retrospectively studied. The drugs which induced fiver injuries were summarized and analyzed. Danan＇s international consensus criteria and Maria＇s diagnostic scale were applied to diagnose these 230 cases again and then the differences of diagnostic results were analyzed and compared. Results The drugs which induced fiver injuries in the 230 patients were arranged in order of their usage frequencies： traditional Chinese herbs and the like, antibiotics, antipyretic analgesics, antituberculosis medicines, cardiovascular drugs, over-the-counter health stuff, psychopharmaceuticals, dermatological agents, drug for diabetes, tapazol, and others. Based on the 230 adult inpatients with drug-induced liver injury, according to Danan＇s international consensus criteria, 149 cases （64.8%）, 71 （30.9%） and 10 （4.3%） were classified as drug-related, indeterminate and drug-unrelated respectively; according to Mafia＇s diagnostic scale, not one was a definite drug-induced fiver injury, 55 cases （23.9%） were probable, while 126 （54.8%）, 33 （14.3%） and 16 （7.0%） were possible, unlikely and excluded respectively. Conclusions The accordance rate of Danan＇s international consensus criteria and clinical diagnosis was higher than that of Mafia＇s diagnostic scale. Nevertheless, the current diagnostic methods for drug-induced fiver injury need to be revised for clinical practice.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2007年第12期926-929,共4页
Chinese Journal of Hepatology
关键词
肝疾病
药物性
诊断
药物性肝损害
比较
Liver diseases, drug-induced
Diagnosis, drug-induced fiver injury
Comparison
