摘要
目的分析近年来引起药物性肝病的病因、临床特点、诊断及预后,以加深对该病的认识,从而规范用药,减少药物性肝病的发生,并为预防和早期治疗该病提供参考。方法对从我院2007年1月至2010年12月住院诊断药物性肝病患者进行回顾性分析,参照Maria的"临床诊断量表(CDS)"进行评分,并分析其临床特点。结果在185例患者中,按Maria评分,10～13分(可能为药物性肝病)者63例,14～17分(很可能为药物性肝病)者为122例;肝细胞损伤型151例(81.6%),胆汁淤积型27例(14.6%),混合型7例(3.9%);引起肝病的可疑药物按百分比由高到低依次为中草药(占25.9%,48/185例)、抗结核药(占16.8%,31/185例)、抗肿瘤药(11.4%,21/185)、抗生素类药(6.5%,12/185)、抗甲状腺药(5.4%,10/185)、降脂药及心血管病药(4.9%,9/185)等。主要表现为乏力(70.3%)、食欲不振(61.1%)、厌油腻(54.6%)、尿黄(53.0%),且有21.1%的患者无症状。多数患者预后良好,治疗后总有效率95.8%。结论中草药、抗结核药、抗肿瘤药和抗生素药物是引起药物性肝病的主要病因,绝大多是发生在12周内。药物性肝病的主要临床类型为肝细胞损伤型,其临床特点与各类急、慢性肝胆疾病相似,无特异性,早期发现、及时停用肝损害药物是治疗的前提,绝大部分药物性肝病预后良好。
Objective In order to enhance the understanding and improve the treatment and early diagnosis of a- cute drug- induced liver disease, we analyzed the etiology, clinical features, diagnosis and prognosis of drug- in- duced liver disease in recent years. Methods From January 2007 to December 2010, 185 cases confirmed acute drug-induced liver disease in our hospital according to Mariag Clinical Diagnostic Scale （CDS） were retrospec- tively reviewed. The clinical features of drug-induced liver disease were analyzed. Results With Mariag diag- nostic scale in 185 patients, 63 cases scored 10 to 13 points （possibly drug-induced liver disease） , 122 cases scored 14 to 17 points （probably drug- induced liver disease）. Among them, 151 cases were hepatocellular type （81.6%）, 27 cases were cholestatic type （ 14.6% ） and 7 cases were mixed type （3.9%）. Suspicious drugs f to cause liver disease by percentage descending order were Chinese herbal medicine （25.9%） , antituberculosis drugs （16.8%）, antineoplastic agents （11.4%）, antibiotics drugs （6.5%）, anti-thyroid drugs （5.4%）, lipid-lowering drugs and cardiovascular disease drugs （4.9%）. The principal clinical manifestation included fatigue （70.3%）, anorexia （61.1%）, tired of greasy （54.6%）, colored urine （53.0%）, and 21.1% pa- tients had no symptoms. Most patients were cured with good prognosis. The total effect was 95.8% after treat- ment. Conclusion Chinese herbal medicine, anti-TB drugs, anticancer drugs and antibiotics are the major cause of drug-induced liver injury, the vast majority occurred in the 12 weeks. The main clinical type of drug- induced liver injury is hepatocellular type ; its clinical features are non- specific, similar with varieties of acute/ chronic liver and gallbladder diseases. Early detection, timely disabling liver damage drugs is a prerequisite for treatment. The vast majority of drug-induced liver disease prognosis is good.
出处
《标记免疫分析与临床》
CAS
2012年第6期324-327,共4页
Labeled Immunoassays and Clinical Medicine
关键词
药物性肝病
中草药
临床特点
Drug-induced liver disease
Herbs
Clinical feature
