CAJ | 학술논문

目的探讨老年人急性药物性肝损伤的病因、分型和肝功能变化特点.方法采用急性药物性肝损伤诊断标准及国际共识分型标准,回顾性分析近10年来我院167例因急性药物性肝损伤住院患者的临床资料.结果急性药物性肝损伤患者167例,老年组和中青年组分别为53例(31.7%)和114例(68.3%);导致急性药物性肝损伤最常见的药物为中药类(47.9%),老年组心血管系统用药比例高于中青年组(P＜0.05),临床表现以乏力(50.3%)和黄疸(46.7%)者多见,无明显临床表现者仅25例(15.0%),老年组与中青年组临床表现差异无统计学意义;老年组肝细胞型、胆汁淤积型和混合型肝损伤分别为40例(75.5%)、5例(9.4%)和8例(15.1%),中青年组分别为91例(78.9%)、8例(7.4%)和15例(13.7%),两组比较差异无统计学意义(x2=0.80,P＞0.05).结论老年患者药物性肝损伤以中草药类及心血管药物为主,临床表现缺乏特异性.
목적 탐토노년인급성약물성간손상적병인、분형화간공능변화특점.방법 채용급성약물성간손상진단표준급국제공식분형표준,회고성분석근10년래아원167례인급성약물성간손상주원환자적림상자료.결과 급성약물성간손상환자167례,노년조화중청년조분별위53례(31.7%)화114례(68.3%);도치급성약물성간손상최상견적약물위중약류(47.9%),노년조심혈관계통용약비례고우중청년조(P＜0.05),림상표현이핍력(50.3%)화황달(46.7%)자다견,무명현림상표현자부25례(15.0%),노년조여중청년조림상표현차이무통계학의의;노년조간세포형、담즙어적형화혼합형간손상분별위40례(75.5%)、5례(9.4%)화8례(15.1%),중청년조분별위91례(78.9%)、8례(7.4%)화15례(13.7%),량조비교차이무통계학의의(x2=0.80,P＞0.05).결론 노년환자약물성간손상이중초약류급심혈관약물위주,림상표현결핍특이성.
Objective To investigate the causes, clinical features, classifications and liver function change of drug-induced liver damage (DILD) in the elderly. Methods One hundred and sixty seven inpatients with acute drug-induced liver injury in our hospital in the past ten years (January 2000 to December 2009) were retrospectively investigated,and the diagnosis and classification methods of acute DILD were based on international consensus meeting (international criteria). Results Among 167 DILI cases, there were 53 cases (31.7%) in the older group and 114 cases (68.3%) in middle-youth age group. Fatigue and jaundice were the more common symptoms, accounting for 50.3% and 46.7%, respectively. In 167 cases, no obvious symptoms and signs were shown in 25 cases. There were no significance differences in clinical manifestation between two groups. Many drugs could induce liver injury. The most common drugs inducing DILD were Chinese traditional and herbal drugs, accounting for 47.9%. Drugs used in heart diseases and inducing liver injury were more common in the older group. In this study, 40 (75.5%), 5 (9.4%) and 8 (15.1%) cases were designated as hepatocellular, cholestetic and mixed DILD in the older group, and 91 (78.9%), 8 (7.4%) and 15 (13.7%) in middle-youth age group, respectively. There were no significance differences between two groups in classifications. Conclusions Many drugs could cause liver injury. The symptoms of acute DILD are nonspecific. Drugs used in heart diseases and inducing liver injury are more common in older patients.