CAJ | 학술논문

目的：探讨我国简化的急性药物性肝损伤（DILI）诊断方法在诊断急性 DILI 中的可靠性。方法纳入2008年至2013年诊断为急性 DILI 的320例患者，收集其病历资料，以国际公认的Roussel Uclaf 因果关系评估方法（RUCAM ）为对照，评价我国简化的急性 DILI 诊断方法。统计学分析采用方差分析，对两种诊断方法判断结果计算 Gamma 值，进行相关性分析。结果320例急性 DILI 患者中，采用 RUCAM 评价方法的结果为，非常可能相关39例（12．19％），很可能相关193例（60．31％），可能相关74例（23．12％），不大可能相关11例（3．44％），无关3例（0．94％）；采用简化的急性 DILI 诊断方法的结果为，确诊194例（60．62％），疑似103例（32．19％），排除23例（7．19％）。确诊组平均RUCAM评分为（7．5±1．2）分，高于疑似组的（5．3±1．3）分和排除组的（2．1±1．1）分，差异有统计学意义（F＝239．545，P ＜0．01）。对这两种诊断方法判断结果进行相关性分析，Gamma 值为0．955（ P ＜0．01）。结论我国简化的急性 DILI 诊断方法与 RUCAM 评分方法较为一致，且简单、实用，可作为筛选急性 DILI 的临床途径之一。
목적：탐토아국간화적급성약물성간손상（DILI）진단방법재진단급성 DILI 중적가고성。방법납입2008년지2013년진단위급성 DILI 적320례환자，수집기병력자료，이국제공인적Roussel Uclaf 인과관계평고방법（RUCAM ）위대조，평개아국간화적급성 DILI 진단방법。통계학분석채용방차분석，대량충진단방법판단결과계산 Gamma 치，진행상관성분석。결과320례급성 DILI 환자중，채용 RUCAM 평개방법적결과위，비상가능상관39례（12．19％），흔가능상관193례（60．31％），가능상관74례（23．12％），불대가능상관11례（3．44％），무관3례（0．94％）；채용간화적급성 DILI 진단방법적결과위，학진194례（60．62％），의사103례（32．19％），배제23례（7．19％）。학진조평균RUCAM평분위（7．5±1．2）분，고우의사조적（5．3±1．3）분화배제조적（2．1±1．1）분，차이유통계학의의（F＝239．545，P ＜0．01）。대저량충진단방법판단결과진행상관성분석，Gamma 치위0．955（ P ＜0．01）。결론아국간화적급성 DILI 진단방법여 RUCAM 평분방법교위일치，차간단、실용，가작위사선급성 DILI 적림상도경지일。
Objective To explore the reliability of Chinese simplified diagnostic method for acute drug‐induced liver injury (DILI) in diagnosis of acute DILI .Methods From 2008 to 2013 ,a total of 320 patients diagnosed with acute DILI were enrolled .The clinical data of them were collected .International recognized Roussel Uclaf causality assessment method (RUCAM ) was taken as control and then simplified diagnostic method for DILI in China was evaluated . Variance analysis was performed for statistical analysis .Gamma value of two diagnostic methods was calculated and the correlation was analyzed .Results Among the 320 patients with acute DILI ,according to RUCAM ,there were 39 cases (12 .19% ) with quite high probability ,193 with high probability (60 .31% ) ,74 with possibility (23 .12% ) ,11 with less possibility (3 .44% ) and three with no probability (0 .94% ) .According to simplified diagnostic method for acute DILI ,194 cases were diagnosed (60 .62% ) ,103 were suspicious (32 .19% ) and 23 were excluded (7 .19% ) .The RUCAM score of diagnosed group (7 .5 ± 1 .2) was higher than that of suspicious group (5 .3 ± 1 .3) and excluded group (2 .1 ± 1 .1) ,and the difference was statistically significant (F =239 .545 ,P< 0 .01) .The correlation analysis between these two diagnostic methods indicated that Gamma value was 0 .955 (P < 0 .01) .Conclusions The simplified diagnostic method for acute DILI in China is simple ,practical and consistent with RUCAM .It can be used as one of the clinical methods for screening acute DILI .