摘要
目的探讨药物性肝炎(DILD)的致病原因及其临床表现和转归。方法回顾性分析424例DILD患者的临床症状、实验室指标、基础疾病、肝损伤药物种类及预后等临床资料,分析其致病原因及临床特征。结果肝胆疾病、免疫功能失调、糖尿病、高血压、长期饮酒、年龄≥55岁均是导致DILD的危险因素。男155例(36.56%),女269例(63.44%),差异有统计学意义(P<0.01);中药引起的DILD患者257例(60.61%),发生率居前3位为何首乌17例(6.61%),雷公藤11例(4.28%),土三七8例(3.11%);西药引起的DILD有167例(39.39%),发生率居前3位为抗结核药物72例(43.11%)、精神类药物27例(16.17%)、非甾体抗炎药17例(10.18%)。中药和西药对肝损伤的影响无显著性差异(P=0.239);经内科综合治疗,中药与西药所致DILD患者均预后良好,差异无统计学意义(P=0.889)。结论 DILD临床表现缺乏特异性,多为隐匿发病,与所用治疗药物有关,还与患者本身体质相关,对伴疾病危险因素的患者应注意DILD的预防,经临床综合治疗大多预后良好。
Objective To investigate the pathogenic factors, clinical manifestations and prognosis of drug induced liver disease （ DILD ） . Methods The clinical data of clinical symptoms, laboratory indexes, basic diseases, types of liver injury drugs and prognosis of 424 pa-tients with DILD was analyzed retrospectively, in order to analyze the pathogenic factors and clinical features. Results Hepatobiliary dis-eases, immune dysfunction, diabetes, hypertension, long-term drinking, over 45 years old were the risk factors of DILD. In 424 cases, there were 155 males （ 36. 56% ） and 269 females （ 63. 44% ） , the difference was statistically significant （ P 〈 0. 01 ） . Totally 257 cases （ 60. 61%） of DILD caused by traditional Chinese medicine, among the top 3, there were 17 cases （ 6. 61%） of Polygonum multiflorum, 11 cases （ 4. 28% ） of Tripterygium wilfordii, 8 cases （ 3. 11% ） of Sedum aizoon. Totally 167 cases （ 39. 39% ） of DILD caused by Western medicine, among the top 3, there were 72 cases （ 43. 11% ） of anti-tuberculosis drugs, 27 cases （ 16. 17% ） of psychotropic drugs, and 17 cases （ 10. 18%） of non steroidal anti-inflammatory drugs. There were no significant differences in the effects of Chinese medicine and Western medicine on liver injury （ P=0. 239 ） . After comprehensive treatment of internal medicine, the prognosis of DILD patients induced by traditional Chinese medicine or Western medicine was good, the difference was not statistically significant （ P=0. 889 ） . Conclusion The clinical manifestations of DILD are lack of specificity, mostly for occult diseases. DILI is not only associated with the treatment of drugs, but also with the patient′s own physique. For patients with disease risk factors, attention should be paid to the prevention of DILD. After comprehensive treatment, most DILD patients have good prognosis.
出处
《中国药业》
CAS
2017年第19期82-84,共3页
China Pharmaceuticals
关键词
药物性肝炎
临床表现
合理用药
多因素分析
drug induced liver disease
clinical manifestations
rational drug use
multifactorial correlation analysis
