摘要
药物性肝损伤(DILI)是重要的药物不良反应,严重者可导致急性肝衰竭甚至死亡。目前,DILI的诊断仍是排他性的策略,因此,详细的病史采集、全面仔细地排除肝损伤的其他潜在病因,是建立正确诊断的关键。本指南根据最新研究进展提供的循证医学证据制定,旨在为临床医生在实践中如何及时识别疑似DILI患者,规范诊断和管理提供专业的指导。根据我国的实际情况,指南也专门重点阐述了慢性肝病基础上的DILI、药物导致的肝炎病毒再激活、DILI的常见病因(草药和膳食补充剂、抗结核药物、抗肿瘤药物),以及临床试验中DILI的信号和评估等内容。
Drug-induced liver injury(DILI)is an important adverse drug reaction that can lead to acute liver failure or even death in severe cases.Currently,the diagnosis of DILI still follows the strategy of exclusion.Therefore,a detailed history taking and a thorough and careful exclusion of other potential causes of liver injury is the key to correct diagnosis.This guideline was developed based on evidence-based medicine provided by the latest research advances and aims to provide professional guidance to clinicians on how to identify suspected DILI timely and standardize the diagnosis and management in clinical practice.Based on the clinical settings in China,the guideline also specifically focused on DILI in chronic liver disease,drug-induced viral hepatitis reactivation,common causing agents of DILI(herbal and dietary supplements,anti-tuberculosis drugs,anti-neoplastic drugs),and signal and assessment of DILI in clinical trials.
作者
中国医药生物技术协会药物性肝损伤防治技术专业委员会
中华医学会肝病学分会药物性肝病学组
茅益民
马世武
刘成海
刘晓琰
苏明华
李东良
李异玲
陈公英
陈军
陈金军
赵景民
郭晓燕
唐洁婷
诸葛宇征
谢青青
谢雯
赖荣陶
蔡大川
蔡庆贤
Technology Committee on DILI Prevention and Management,Chinese Medical Biotechnology Association;Study Group of Drug-Induced Liver Disease,Chinese Medical Association for the Study of Liver Diseases;Mao Yimin(不详;Renji Hospital,School of Medicine,Shanghai Jiao Tong University Shanghai Institute of Digestive Disease,Shanghai Research Center of Fatty Liver Disease,Shanghai 200001,China)
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2023年第4期355-384,共30页
Chinese Journal of Hepatology
基金
国家重点研发计划(2022YFC3502101)
国家科技部十三五科技重大专项(2017ZX09304016)
国家自然科学基金(81970513、82270619)。
关键词
药物性肝损伤
指南
诊断
治疗
管理
Drug-induced liver injury
Guidelines
Diagnosis
Treatment
Management
