摘要
目的:了解唑类抗真菌药物致药物性肝损伤的现状,探讨有效的防治措施,为临床安全、合理使用唑类抗真菌药物提供参考。方法:收集1989年1月-2014年12月我国公开发表的医药学期刊中有关唑类抗真菌药物致药物性肝损伤的个案报道,对唑类抗真菌药物致药物性肝损伤患者的年龄、性别、药品名称、用法用量、出现症状时间、转归等情况进行统计、分析。结果:共收集到相关文献36篇共50例个案报道,包括酮康唑致肝损伤29例(58%)、氟康唑致肝损伤9例(18%)、伊曲康唑致肝损伤8例(16%)、伏立康唑致肝损伤4例(8%)。药物性肝损伤患者的肝损伤与患者年龄、性别、用药疗程不相关,治愈率为88%。转归较差的患者6例(12%),其中4例经治疗无效死亡,2例因病情危重放弃治疗。因联合用药致药物性肝损伤的患者2例。结论:患者在服用唑类抗真菌药物时应定期检测肝功能和监测血药浓度,有条件时行基因检测,可降低肝损伤风险。确诊的药物性肝损伤患者应立即停药,及时进行退黄、降酶等保肝治疗或人工肝血浆置换、肝移植等手术治疗。
OBJECTIVE：To investigate the situation of drug-induced liver injury caused by azole antifungal drug and discuss effective prevention and treatment measures,to provide reference for safe and rational use of azole antifungal drug in the clinic.METHODS：Drug-induced liver injury caused by azole antifungal drug were collected from published medical and pharmaceutical periodicals in China during Jan.1989-Dec. 2014,and then analyzed statistically in respects of patient＇s age and gender,drug name,usage and dosage,onset time,outcome,etc. RESULTS：A total of 36 literatures were collected,involving 50 cases. Drug-induced liver injury were not related to patient＇s age, gender and treatment duration with cure rate of 88%. There were 29 cases of ketoconazole-induced liver injury（58%）,9 cases of fluconazol-induced liver injury（18%）,8 cases of itraconazole-induced liver injury（16%）and 4 cases of voriconazole-induced liver injury（8%）. There were 6 cases of poor outcome（12%）,of which 4 patients died due to treatment failure and 2 patients gave up treatment because of critical condition. 2 patients suffered from drug-induced liver injury caused by drug combination. CONCLUSIONS：Regular liver function detection and drug concentration monitoring should be provided for the patients when they use azole antifungal drug,and gene detection should be conducted when avalilable to reduce the risk of liver injury. The patients diagnosed as drug-induced liver injury should stop taking medicine immediately and receive supportive liver protection therapy as removing jaundice,enzyme reduction,artificial liver plasma exchange,liver transplantation and other surgery.
出处
《中国药房》
CAS
北大核心
2016年第11期1496-1499,共4页
China Pharmacy
基金
无锡市医院管理中心2013年度医学科研药学项目(No.YGZXY1301)
关键词
唑类抗真菌药物
药物性肝损伤
病例分析
Azole antifungal drug
Drug-induced liver injury
Case analysis
