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药物性肝损害临床分析(附60例报告) 被引量:4

Clinical analysis of drug-induced liver injury
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摘要 [目的]探讨引起药物性肝损害的常见药物,分析药物性肝损害的临床特点、治疗及其疗效。[方法]回顾性分析2005年1月~2009年12月60例药物性肝损害患者的临床资料。[结果]5年内60例药物性肝损害中,肝细胞损伤型30例(50.0%),胆汁瘀积型18例(30.0%),混合型12例(20.0%)。均有明确的服用药物史,且发生时间多在服药后2~4周。以中药、中成药、抗生素、抗甲状腺药、抗结核药常见。临床症状以上腹不适、乏力、纳差、恶心、呕吐、黄疸为主,肝功能检查有不同程度的转氨酶、胆红素、碱性磷酸酶等指标升高。经停药,给予护肝及对症支持治疗,必要时糖皮质激素治疗,肝损害大多可恢复。[结论]在临床工作中应重视药物的不良反应,避免肝损害的发生。一旦发生了肝损害,要给予积极有效治疗。 [Objective]To investigate the common drugs that induce liver injury and analyse drug-induced liver injury about its clinical characteristics,treatment and efficacy.[Methods]The clinical data of 60 patients with drug-induced hepatitis from January 2005 to December 2009 were retrospectively analyzed.[Results]Among 60 patients with liver injury during 5 years,the hepatocellular pattern accounted for 30 cases(50%),the cholestatic pattern 18 cases(30%),the mixed type 12 cases(20%).All the 60 cases had specific medication histories and usually resulted in liver injury after 2-4 weeks.Drug-induced liver injury can be induced by many drugs,such as traditional Chinese medicine,antibiotics,anti-thyroid drugs and anti-tuberculosis drugs and etc.The main symptoms included abdominal pain,fatigue,anorexia,nausea,vomiting,jaundice.Liver function tests were characterized by a predominant rise in the serum transaminases,bilirubin and alkaline phosphatase.Most of the patients were recoverable after withdrawal,liver treatment and active supportive care,steroid therapy when necessary.[Conclusion]In the clinical work,we should focus on the side effects of the drugs to avoid liver injury.Once it occurred,the positive and effective treatment should be given.
出处 《中国中西医结合消化杂志》 CAS 2011年第3期175-178,共4页 Chinese Journal of Integrated Traditional and Western Medicine on Digestion
关键词 药物/中毒 药物性肝损害 药物毒副作用 drug/toxicity drug-induced liver injury drug toxicity
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