摘要
目的探讨药源性肝损伤(DILI)临床特点及发生规律,降低药品不良反应发生率,促进临床合理用药。方法对我院2015年1月-2017年12月发生的106例药源性肝损伤患者的年龄、性别、发病时间、用药品种、临床特征等资料进行回顾性分析,使用SPSS 22.0对数据进行统计学分析,计数资料用百分比表示,计量资料用均数±标准差(±s)表示,多组均数比较采用单因素方差分析。结果男性40例,女性66例,平均年龄(48.12±14.00)岁;药物按构成比依次为是中药、抗肿瘤药、非甾体抗炎药和抗感染药物;开始用药至起病多在12周内,特征以身目黄染、尿液颜色加深、乏力、食欲减退、恶心、呕吐、腹胀等为主,18.4%无症状;临床分型以肝细胞损伤型最多(41.51%)、混合型(28.30%)次之,胆汁淤积型(15.09%)和肝生化学异常(15.09%)最少;50例病理结果均倾向药物性肝损伤。结论药源性肝损伤临床特征不特异,易漏诊和误诊,但大多数预后较好。临床医生应该加强对DILI的警惕,根据其病因、临床特征,早期识别、及时停药并给予适当保肝治疗。
Objective To investigate the clinical characteristics and occurrence of drug-induced liver injury(DILI),so as to reduce the incidence of adverse drug reactions and promote the rational use of drugs.Methods A retrospective analysis was performed on106patients with drug-induced liver injury in our hospital from January 2015 to December2017.The data were statistically analyzed by SPSS22.0.The count data expressed as a percentage,measurement data with mean±standard deviation(χ^-±s),multiple groups were compared using single factor analysis of variance.Results There were 40 males and66females with a mean age of(48.12±14.00)years involved.The drugs were orderly ranked traditional Chinese medicine,antineoplastic agents,NSAIDs and anti-infective drugs according to their constituent ratios.The time to onset was within12weeks with characteristics of yellow skin,darker urine,decreased appetite,nausea,vomiting and abdominal distension,while 18.4% of patients were asymptomatic.The types of injury were hepatocellular injury(41.51%),mixed type(28.30%)followed by cholestasis type(15.09%)and liver biochemical abnormality(15.09%).The pathological results of50patients tended to be drug-induced liver injury.Conclusion Clinical characteristics of drug-induced liver injury were not specific and easy to misdiagnose.However,most of the prognoses were good.Clinicians should strengthen their vigilance against DILI and carry out early identification,timely withdraw suspected drugs and apply appropriate hepatoprotective therapy based on etiology and clinical features.
作者
闫荟羽
史吉平
毛丽超
张四喜
YAN Huiyu;SHI Jiping;MAO Lichao;ZHANG Sixi(Pharmacy Department of The First Hospital of Jilin University,Jilin Changchun 130021,China;Pharmacy College of Jilin University,Jilin Changchun 130021,China)
出处
《中国药物警戒》
2018年第11期677-681,共5页
Chinese Journal of Pharmacovigilance
关键词
药源性肝损伤
不良反应
回顾性分析
drug-induced liver injury
adverse reactions
retrospective analysis
