摘要
目的分析小儿药物性肝损伤的原因及临床特点，以期指导临床减少小儿药物性肝损伤的发生。方法回顾性分析年龄〈14岁小儿药物性肝损伤患者资料，对其用药情况、年龄分布、临床表现、肝脏生物化学指标和肝组织病理学特点进行分析。偏态分布计量资料采用秩和检验分析。结果共收集31例小儿药物性肝损伤患者资料，占同期因药物性肝损伤住院患者的1．7％，其中男性20例，女性11例，年龄4个月～14岁，平均年龄（8．8±3．9）岁。用药种类以抗菌药最常见（41．9％），其次为中药制剂（29．d％）和解热镇痛药（19．4％）。单一用药为9例（29．0％），联合用2种或2种以上药物22例（71．0％）。临床分型：肝细胞型8例（25．8％），胆汁淤积型8例（25．8%），混合型15例（48．4％）。患儿平均住院天数25．22d。结论引起小儿药物性肝损伤的主要药物依次为抗菌药、中药制剂和解热镇痛药；联合用药是引起小儿药物性肝损伤的重要原因。混合型为主要临床类型。大多数患儿预后良好，肝衰竭或合并血液病患儿预后较差。
Objeelive To investigate the clinical characteristics and responsible agents of drug-induced liver injury （DILl） in pediatric patients. Methods Thirty-one cases of DILI treated in our hospital＇s pediatric ward were retrospectively analyzed. The clinical data for each patient were extracted from the patient＇s medical records, and included reported causes, physical and biochemical features, natural history, blood examination results, and hepatic pathology findings. Results The 31 pediatric cases of DILI accounted for 1.7% of the 1831 total cases of drug-induced liver injury treated at our hospital between February 2002 to June 2011. The pediatric DILl population was composed of 20 males and 11 females, with an average age of 8.8：t：3.9 years old （range, 0.3-14.0）. The liver injury patterns represented among the cases were： hepatocellular （25.8%）, cholestasis （25.8%）, and mixed hepatocellular-cholestatic （48.4%）. Antimicrobials were the most common cause （41.9%） of DILl, followed by the herbal medicine （29.0%） and febrifuge drugs （19.4%）. A single drug was implicated in nine cases （29.0%）, and two or more drugs were implicated in 22 cases （71%）. Most of the children had good prognosis, but those with pre-existing disease had poor prognosis. One child died of hepatic failure, waking the death rate 3.23%. The average hospitalization time was 25.2 days, and the patients with hepatocellular injury had shorter hospitalization time than those with mixed injury. Conclusion Drug-induced liver injury in our pediatric population was most often caused by antimicrobials, followed by herbal medicine and febrifuge drugs. Most patients presented with mixed hepatoeelhilar-cholestatie injury. Children with pre- existing diseases or hepatic failure had poor prognosis.
出处
《中华肝脏病杂志》
CAS
CSCD
北大核心
2012年第3期193-195,共3页
Chinese Journal of Hepatology
关键词
药物性肝损伤
病理学
临床
Drug-induced liver injury
Pathology
Clinical features
