环丙沙星致肝损害32例文献分析

Analysis of Thirty-two Liver Injury Cases Induced by Ciprofloxacin

关键词:  环丙沙星  氟喹诺酮类  肝损害  药源性疾病

Key words:  ciprofloxacin  fluoroquinolones  liver injury  drug-induced disease

摘要:

目的 探讨环丙沙星致肝损害的规律与特点，为临床医生合理用药提供参考。方法 检索国内外有关医药数据库，下载病例报告原文进行统计与分析。结果 环丙沙星致肝损害病例报告32例，其中男性22例，40岁以上的中老年人23例。肝损害的主要临床表现为黄疸、恶心、腹痛、转氨酶升高，以肝细胞型为主，胆汁淤积型次之，混合型少见。中老年、男性、药物过敏史、原患肝病、合并肝毒性药物、再次用药、剂量过大、疗程过长等属高危人群和危险因素。经停药、采取相应治疗措施，大部分可恢复正常，但也可进展为慢性化、肝衰竭，严重者死亡。已有至少3例死亡报告。结论 环丙沙星的肝损害严重不良反应应引起临床医务人员的高度重视。

Abstract:

OBJECTIVE To investigate the characteristics and regularities of liver injury induced by ciprofloxacin, and provide a reference for clinicians in rational drug use. METHODS To retrieve the related medicine databases from domestic and abroad, and download the case reports and analyze them. RESULTS There were 32 cases of liver injury induced by ciprofloxacin in which 22 cases were male, 23 cases were more than 40 years-old. The main clinical manifestations of liver injury induced by ciprofloxacin were jaundice, nausea, abdominal pain, elevated transaminases. The main types of liver injury were hepatocellular type and cholestatic type. Mixed type was rare. The high-risk groups and high-risk factors were older, male, drug allergy history, primary liver disease, combined application of the drugs with liver toxicity, the causative drugs again, excessive dosage of drugs, too long course of treatment. The most cases returned to normal after drug withdrawal and corresponding treatments. The liver injury could progress to chronic and liver failure, even death. There were at least three death cases. CONCLUSION The liver injury induced by ciprofloxacin is a serious adverse drug reaction, and should be paid attention for the clinicians.