中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2013年
5期
361-365
,共5页
肝炎,慢性、药物性%综述文献%回顾性研究
肝炎,慢性、藥物性%綜述文獻%迴顧性研究
간염,만성、약물성%종술문헌%회고성연구
Hepatitis,chronic,drug-induced%Review literature%Retrospective studies
目的 分析2007-2011年中国期刊全文数据库(CNKI)载录的有关药物性肝损伤的临床文献,探讨药物性肝损伤的原因、特点和预后,为临床安全用药提供参考.方法 以“药物性肝损伤”为关键词,检索CNKI载录的2007-2011年的相关临床病例资料文献,对文献中患者的年龄、性别、用药情况、临床表现、分型和预后等数据进行统计分析.结果 共检索到文献281篇,其中符合纳入标准111篇文献,共10 693例药物性肝损伤(DILI)患者的资料进行统计汇总.药物性肝损伤男性略多于女性,发病年龄最大为93岁,最小为7个月,平均为45.6岁.最高发的年龄段为41 ～ 60岁(421例,38.52％),＞60岁老年人占20.68％ (226/1093).43.51％的患者(2868/6592)无自觉症状,经体检或常规检查发现肝功能异常,其余患者以乏力、纳差、恶心呕吐等消化道非特异性症状及黄疸为主要表现.引起肝损伤的药物几乎涉及了所有种类的临床药物和保健品,其中居前6位的是抗结核药(32.74％,3058/9340)、中药(22.12％,2066/9340)、抗微生物药(9.18％,857/9340)、抗肿瘤药(6.34％,592/9340)、解热镇痛药(4.80％,448/9340)和甲状腺功能亢进用药(4.37％,408/9340).临床分型中肝细胞损伤型最多见(63.66％,4438/6971).患者大多预后良好,病死率仅1.67％(114/6809).结论 抗结核药、中药、抗微生物药是引起药物性肝损伤的主要病因,部分患者起病隐匿,临床表现缺乏特异性,及时处理大多可治愈或好转.
目的 分析2007-2011年中國期刊全文數據庫(CNKI)載錄的有關藥物性肝損傷的臨床文獻,探討藥物性肝損傷的原因、特點和預後,為臨床安全用藥提供參攷.方法 以“藥物性肝損傷”為關鍵詞,檢索CNKI載錄的2007-2011年的相關臨床病例資料文獻,對文獻中患者的年齡、性彆、用藥情況、臨床錶現、分型和預後等數據進行統計分析.結果 共檢索到文獻281篇,其中符閤納入標準111篇文獻,共10 693例藥物性肝損傷(DILI)患者的資料進行統計彙總.藥物性肝損傷男性略多于女性,髮病年齡最大為93歲,最小為7箇月,平均為45.6歲.最高髮的年齡段為41 ～ 60歲(421例,38.52％),＞60歲老年人佔20.68％ (226/1093).43.51％的患者(2868/6592)無自覺癥狀,經體檢或常規檢查髮現肝功能異常,其餘患者以乏力、納差、噁心嘔吐等消化道非特異性癥狀及黃疸為主要錶現.引起肝損傷的藥物幾乎涉及瞭所有種類的臨床藥物和保健品,其中居前6位的是抗結覈藥(32.74％,3058/9340)、中藥(22.12％,2066/9340)、抗微生物藥(9.18％,857/9340)、抗腫瘤藥(6.34％,592/9340)、解熱鎮痛藥(4.80％,448/9340)和甲狀腺功能亢進用藥(4.37％,408/9340).臨床分型中肝細胞損傷型最多見(63.66％,4438/6971).患者大多預後良好,病死率僅1.67％(114/6809).結論 抗結覈藥、中藥、抗微生物藥是引起藥物性肝損傷的主要病因,部分患者起病隱匿,臨床錶現缺乏特異性,及時處理大多可治愈或好轉.
목적 분석2007-2011년중국기간전문수거고(CNKI)재록적유관약물성간손상적림상문헌,탐토약물성간손상적원인、특점화예후,위림상안전용약제공삼고.방법 이“약물성간손상”위관건사,검색CNKI재록적2007-2011년적상관림상병례자료문헌,대문헌중환자적년령、성별、용약정황、림상표현、분형화예후등수거진행통계분석.결과 공검색도문헌281편,기중부합납입표준111편문헌,공10 693례약물성간손상(DILI)환자적자료진행통계회총.약물성간손상남성략다우녀성,발병년령최대위93세,최소위7개월,평균위45.6세.최고발적년령단위41 ～ 60세(421례,38.52％),＞60세노년인점20.68％ (226/1093).43.51％적환자(2868/6592)무자각증상,경체검혹상규검사발현간공능이상,기여환자이핍력、납차、악심구토등소화도비특이성증상급황달위주요표현.인기간손상적약물궤호섭급료소유충류적림상약물화보건품,기중거전6위적시항결핵약(32.74％,3058/9340)、중약(22.12％,2066/9340)、항미생물약(9.18％,857/9340)、항종류약(6.34％,592/9340)、해열진통약(4.80％,448/9340)화갑상선공능항진용약(4.37％,408/9340).림상분형중간세포손상형최다견(63.66％,4438/6971).환자대다예후량호,병사솔부1.67％(114/6809).결론 항결핵약、중약、항미생물약시인기약물성간손상적주요병인,부분환자기병은닉,림상표현결핍특이성,급시처리대다가치유혹호전.
Objective To analyze the clinical characteristics of drug-induced liver injury (DILI) from Chinese literatures published in Chinese Periodical Full-text Database (CNKI) from 2007 to 2011.Methods Using drug-induced liver injury as key words,the literatures in CNKI were searched,and the data of age,gender,medication,clinical manifestation and prognosis were analyzed.Results In search of CNKI,281 literatures were collected; finally 111 relevant papers were obtained.Total 10 693 cases of DILI were included with a male/female ratio of 1.14:1 and a mean age of 45.6 y ranging from 7 months to 93 y.Among 1093 cases with the age grouped,the highest incidence of DILI was in age 41-60 y(38.52％)and 20.68％ patients were over 60 y.Among 6592 cases with clinical manifestation recorded,43.51％ patients were asymptomatic and abnormal liver function was detected in health check-up; and others presented nonspecific gastrointestinal symptoms,including fatigue,nausea,vomiting and jaundice.In 9340 cases with medication recorded,the 6 most common drugs inducing DILI were antituberculotics (32.74％),Chinese herbs(22.12％),antibiotics(9.18％),antineoplastics(6.34％),NSAIDs (4.80％)and antithyroid drugs (4.37％).The most common type of toxicity was hepatocellular injury (63.66％,4438/6971).In general the prognosis was good with a fatality rate of 1.67％.Conclusions Antituberculotics and Chinese herbs are the main causes of DILI.Some DILI patients have occult onset and others have nonspecific gastrointestinal symptoms.Most patients have good prognosis if they are treated timely.
