CAJ | 학술논문

目的对急性药物性肝损伤患者进行临床分析,以提高对该病的认识.方法对2005年10月至201 1年5月期间在我院住院的230例急性药物性肝损伤患者的临床资料进行回顾性分析.结果 230例患者中60％以上有乏力、纳差及黄疸,肝功能损伤以ALT、AST、碱性磷酸酶(ALP)及总胆红素变化为主.有肝细胞损伤型185例(80.4％),胆汁淤积型27例(11.7％),混合型18例(7.8％).引起药物性肝损伤的药物种类很多,最多见的为中草药汤剂及中成药(55.2％)、抗结核药(9.6％)和其他抗细菌药(5.2％).218例(94.7％)患者预后良好,预后不良12例(5.3％),包括加重后自动出院4例,死亡8例.结论药物性肝损伤的诊断缺乏“金标准”,易误诊漏诊.引起药物性肝损伤的药物种类很多,应注意中草药、抗结核药、其他抗微生物药等.急性药物性肝损伤多数预后良好,但亦可发生严重肝损害,应尽早发现及时处理.
목적 대급성약물성간손상환자진행림상분석,이제고대해병적인식.방법 대2005년10월지201 1년5월기간재아원주원적230례급성약물성간손상환자적림상자료진행회고성분석.결과 230례환자중60％이상유핍력、납차급황달,간공능손상이ALT、AST、감성린산매(ALP)급총담홍소변화위주.유간세포손상형185례(80.4％),담즙어적형27례(11.7％),혼합형18례(7.8％).인기약물성간손상적약물충류흔다,최다견적위중초약탕제급중성약(55.2％)、항결핵약(9.6％)화기타항세균약(5.2％).218례(94.7％)환자예후량호,예후불량12례(5.3％),포괄가중후자동출원4례,사망8례.결론 약물성간손상적진단결핍“금표준”,역오진루진.인기약물성간손상적약물충류흔다,응주의중초약、항결핵약、기타항미생물약등.급성약물성간손상다수예후량호,단역가발생엄중간손해,응진조발현급시처리.
Objective To review the clinical features of acute drug-induced liver injury.Methods The clinical data of 230 patients with acute drug-induced liver injury admitted to Beijing Ditan Hospital from October 2005 to May 2011 were retrospectively analyzed.Results In 230 patients,more than 60％ had symptoms of fatigue,anorexia,jaundice and liver damage presenting LT,AST,ALP and TBIL changes.The hepatocellular injury type accounted for 80.4％ (185/230),cholestatic type accounted 11.7％ (27/230) and mixed type accounted for 7.8％ (18/230).Chinese herbal medicine or Chinese patent medicine was the most common cause of drug-induced liver injury (55.2％),followed by anti-TB drugs (9.6％) and other anti-bacterial drugs (5.2％).There were 218 cases (94.7％) with favorable prognosis and 12 cases (5.3％) with poor prognosis,including 4 aggravating cases discharged against medical advance and 8 deaths.Conclusion The lack of "gold standard" for the diagnosis of drug-induced liver injury may easily lead to misdiagnosis.Chinese Traditional medicine,anti-TB drugs and other anti-microbial drugs are main causes of drug-induced liver injury.Early detection and timely treatment are important for the management of drug-induced liver injury.