325例药物性肝损伤分析

Analysis of 325 Cases on Drug-Induced Hepatic Injury

关键词:  药物性肝损伤  药品不良反应

Key words:  drug-induced hepatic injury  adverse drug reaction (ADR)

摘要:

目的 分析致肝损伤的药物种类、临床表现，探讨药物性肝损伤的特点，为临床安全用药提供参考。方法 采用回顾性分析的方法，对本院2000—2009年325例药物性肝损伤进行统计分析。结果 325例药物性肝损伤中，男164例，女161例，平均年龄(47.2±17.0)岁，涉及药物156种，其中抗微生物药居首位占23.4%，中药占第2位，为15.1%，激素及其有关药物居第3位，占13.2%。临床分型：肝细胞型损伤241例，淤胆型肝损伤50例，混合型肝损伤26例。结论 致肝损伤的药物主要为抗结核药、抗甲状腺药和免疫抑制剂，特点为部分隐匿发生、临床症状严重，及时处理大部分可治愈或好转。临床医药人员应根据这些特点加强对相关药物的监测，提高合理用药水平。

Abstract:

OBJECTIVE To analyze the characteristics of drug-induced hepatic injury for providing some clinical reference. METHODS All of 325 cases over a 10-year period in our hospital were analyzed retrospectively. RESULTS In 325 cases, there were 164 males and 161 females, with a mean age of 47.2±17.0 years. One hundred and fifty six kinds of drugs were involved, included mainly antibacterial drugs(23.4%), traditional chinese medicines(15.1%), hormones and other related substances(13.2%). Classification of drug-induced hepatic injury was made: hepatocellular injury 241 cases, cholestatic injury 50 cases and mixed type injury 26 cases. CONCLUSION Drug-induced hepatic injury mainly included anti-tuberculosis drugs, antithyroid drugs and immunosuppressants. The characteristic included that hepatic injury were occult onset partly, clinical symptoms were serious and they can cure or improve if they were treated timely. It is important to attach importance to drug-induced hepatic injury.