中华消化病与影像杂志（电子版）
中華消化病與影像雜誌（電子版）
중화소화병여영상잡지（전자판）
2015年
4期
1-3
,共3页
药物性肝损伤%肝炎,自身免疫性%糖皮质激素类%人工器官
藥物性肝損傷%肝炎,自身免疫性%糖皮質激素類%人工器官
약물성간손상%간염,자신면역성%당피질격소류%인공기관
Drug-induced liver injury%Hepatitis,autoimmune%Glucocorticoids%Artificial organ
随着处方药及中草药的应用增多，药物性肝损伤越来越受到重视。中草药和抗结核药物是目前我国药物性肝损伤的主要原因。药物诱导的自身免疫性肝炎与免疫介导的药物性肝损伤较难鉴别。肝脏组织学特征及对激素治疗的反应有助于其鉴别诊断。糖皮质激素对于胆汁淤积表现明显、免疫反应强烈的药物性肝损伤具有治疗作用，应注意早期应用，把握好适应证。人工肝支持系统对重症药物性肝损伤具有较好的疗效，根据具体临床病例，可采用多种模式联合，进行个体化治疗。
隨著處方藥及中草藥的應用增多，藥物性肝損傷越來越受到重視。中草藥和抗結覈藥物是目前我國藥物性肝損傷的主要原因。藥物誘導的自身免疫性肝炎與免疫介導的藥物性肝損傷較難鑒彆。肝髒組織學特徵及對激素治療的反應有助于其鑒彆診斷。糖皮質激素對于膽汁淤積錶現明顯、免疫反應彊烈的藥物性肝損傷具有治療作用，應註意早期應用，把握好適應證。人工肝支持繫統對重癥藥物性肝損傷具有較好的療效，根據具體臨床病例，可採用多種模式聯閤，進行箇體化治療。
수착처방약급중초약적응용증다，약물성간손상월래월수도중시。중초약화항결핵약물시목전아국약물성간손상적주요원인。약물유도적자신면역성간염여면역개도적약물성간손상교난감별。간장조직학특정급대격소치료적반응유조우기감별진단。당피질격소대우담즙어적표현명현、면역반응강렬적약물성간손상구유치료작용，응주의조기응용，파악호괄응증。인공간지지계통대중증약물성간손상구유교호적료효，근거구체림상병례，가채용다충모식연합，진행개체화치료。
With a widely using of prescription medication and herbal supplement,it has been increasingly pay attention to drug-induced liver injury (DILI).Herbal remedies and tuberculostatics are the most common causes of DILI in China.To differentiate between true autoimmune hepatitis triggered by drugs (DI-AIH)and immune mediated DILI still remains a challenge.Histological features and the response to corticosteroid therapy support the diagnosis.Glucocorticoid therapy may be an effective treatment for DILI with obvious cholestasis or strong immune response.Early application should be paid attention to,and indications should be strictly controlled.For severe DILI,the artificial liver support system has been proved to be valuable.Individualized therapy and comprehensive patterns should be advocated according to the specific clinical cases.
