实用药物与临床
實用藥物與臨床
실용약물여림상
Practical Pharmacy and Clinical Remedies
2015年
10期
1238-1241
,共4页
药物性肝损伤%小儿%发病特点%药物种类
藥物性肝損傷%小兒%髮病特點%藥物種類
약물성간손상%소인%발병특점%약물충류
Drug-induced liver injury%Children%Disease characteristics%Types of drugs
目的 探讨小儿肝损伤的发病特点和引起损伤的用药,为规范儿科用药、降低药物性肝损伤发生率提供依据. 方法 选择儿科2013年1月至2014年6月药物性肝损伤病例45例进行临床资料的回顾性分析比较. 结果 年龄≤6岁与>6岁患儿在性别、平均病程、损伤类型方面比较差异无统计学意义( P>0. 05 ). 药物性肝损伤患儿首诊主要表现为纳差和呕吐,主要临床表现为纳差、精神萎靡、乏力、恶心呕吐、腹泻和腹痛等.肝细胞损伤型患儿ALT和AST指标较胆汁淤积型高,ALP、PTA和TB指标较胆汁淤积型低,混合型数据居中,三组比较差异有统计学意义( P<0. 01 ). 抗菌药物、解热镇痛药、阿奇霉素和中药致小儿肝损伤的比例分别为33. 3%、15. 6%、13. 3%、13. 3%. 结论 小儿药物性肝损伤尚无典型特征,诊断时应综合各种临床资料、生化指标、症状体征等,应注意对高危用药的监测和合理应用.
目的 探討小兒肝損傷的髮病特點和引起損傷的用藥,為規範兒科用藥、降低藥物性肝損傷髮生率提供依據. 方法 選擇兒科2013年1月至2014年6月藥物性肝損傷病例45例進行臨床資料的迴顧性分析比較. 結果 年齡≤6歲與>6歲患兒在性彆、平均病程、損傷類型方麵比較差異無統計學意義( P>0. 05 ). 藥物性肝損傷患兒首診主要錶現為納差和嘔吐,主要臨床錶現為納差、精神萎靡、乏力、噁心嘔吐、腹瀉和腹痛等.肝細胞損傷型患兒ALT和AST指標較膽汁淤積型高,ALP、PTA和TB指標較膽汁淤積型低,混閤型數據居中,三組比較差異有統計學意義( P<0. 01 ). 抗菌藥物、解熱鎮痛藥、阿奇黴素和中藥緻小兒肝損傷的比例分彆為33. 3%、15. 6%、13. 3%、13. 3%. 結論 小兒藥物性肝損傷尚無典型特徵,診斷時應綜閤各種臨床資料、生化指標、癥狀體徵等,應註意對高危用藥的鑑測和閤理應用.
목적 탐토소인간손상적발병특점화인기손상적용약,위규범인과용약、강저약물성간손상발생솔제공의거. 방법 선택인과2013년1월지2014년6월약물성간손상병례45례진행림상자료적회고성분석비교. 결과 년령≤6세여>6세환인재성별、평균병정、손상류형방면비교차이무통계학의의( P>0. 05 ). 약물성간손상환인수진주요표현위납차화구토,주요림상표현위납차、정신위미、핍력、악심구토、복사화복통등.간세포손상형환인ALT화AST지표교담즙어적형고,ALP、PTA화TB지표교담즙어적형저,혼합형수거거중,삼조비교차이유통계학의의( P<0. 01 ). 항균약물、해열진통약、아기매소화중약치소인간손상적비례분별위33. 3%、15. 6%、13. 3%、13. 3%. 결론 소인약물성간손상상무전형특정,진단시응종합각충림상자료、생화지표、증상체정등,응주의대고위용약적감측화합리응용.
Objective To investigate the clinical features of pediatric liver damage and the medication,to pro-vide the basis for specification of pediatric medication,reduce the incidence of drug-induced liver injury. Methods Clinical data of 45 cases of drug-induced liver injury in pediatrics department from January 2013 to June 2014 were ret-rospectively analyzed and compared. Results There was no significant difference in sex proportion,average duration,type of injury between the children who were less than 6 years old and children who were more than 6 years old ( P>0. 05). Drug-induced liver injury in children first diagnosed mainly as anorexia and vomiting,the main clinical mani-festations were anorexia,listlessness,fatigue,nausea,vomiting,diarrhea,abdominal pain,and so on. ALT and AST in children with liver cell injury type were higher than that of cholestasis type,with lower ALP,PTA and TB levels,ALP,PTA and TB levels of hybrid type was in the middle among the three types. There were significant difference in the a-bove indexes among the three groups (P<0. 01). The proportion of liver injury induced by antibiotics,anti-inflamma-tory drugs,azithromycin and Traditional Chinese medicine were 33. 3%,15. 6%,13. 3%,13. 3% respective-ly. Conclusion Pediatric drug-induced liver injury has no typical characteristics in identification,and the comprehen-sive clinical data,biochemical indicators,symptoms and signs should be considered in the diagnosis. Medical staffs should pay attention to the monitoring and rational use of high-risk drugs.
