摘要
目的通过回顾性分析44例药物性肝功能衰竭患者的临床特征、预后相关因素,探讨药物诱发肝衰竭的疗效。方法回顾性分析2012年12月~2014年12月首都医科大学附属北京佑安医院44例药物性肝衰竭住院患者的临床资料,对用药种类、临床表现、实验室检查、并发症及预后等相关指标进行分析。结果 44例患者中,女性发生药物性肝衰竭的比例高于男性,发病年龄以中老年为主;引起肝衰竭的药物主要是中药(56.8%)和抗结核药(18.2%);肝衰竭临床分型以急性(9.1%)和亚急性(86.4%)为主;并发症以腹腔积液、电解质紊乱和肝性脑病为主;死亡7例(15.9%)。治愈好转组电解质紊乱和肝性脑病的发生率均低于无效死亡组,差异均有高度统计学意义(P<0.01);对预后判断相关指标分析,治愈好转组凝血酶原活动度高于无效死亡组,差异有统计学意义(P<0.01),两组总胆红素、胆碱酯酶和总胆固醇比较,差异无统计学意义(P>0.05)。结论中药和抗结核药成为药物性肝功能衰竭的主要原因,发生肝性脑病和电解质紊乱提示病情预后恶劣,临床医生应高度重视药物的潜在肝损害,尤其是在使用中药过程中,应定期监测肝功能。
Objective To analyze the clinical features, prognosis associated with factors retrospectively in order to improve the curative efficacy of drug-induced liver failure. Methods From December 2012 to December 2014, fi^rty-four clinical data of patients with drug-induced liver failure in Beijing You＇an Hospital, Capital Medical University were re- viewed according to the drug history, clinical features, laboratory tests, complications and prognosis associated factors. Results The incidence of drug-induced liver failure in the female was higher than that of male, the onse! age was mainly middle-aged and old. The predominant etiological drugs were the traditional Chinese medicine （56.8%） and anti- tubercular agent （18.2%）. The predominant types of liver failure were acute liver failure （9.1%） and sub-acute liver failure （86.4%）, and the common complications were ascites, electrolyte disturbance and hepatic encephalopathy. 7 patients were died （15.9%）. The incidences of hepatic encephalopathy and electrolyte disturbance in the healing group was lower than those of ineffective group, with highly statistically significant differences （P〈 0.01）. The prothrombin activity level in the healing group was higher than those of ineffective group, with highly statistically significant differences （P〈 0.01）. There were no significant differences in total bilirubin, cholinesterase and total cholesterol （P 〉 0.05）. Couclusion Traditional Chinese medicine and anti-tubercular agent are the main etiologies of drug-induced liver failure. The onset of hepatic encephalopathy and electrolyte disorder prompting poor prognosis. Clinical doctors should attach great importance to drug damage potential of liver, especially in the process of using traditional Chinese medicine and the liver function should be monitored regularly.
出处
《中国医药导报》
CAS
2017年第32期112-115,共4页
China Medical Herald
基金
北京市卫生系统高层次卫生技术人才培养项目(2015-3-103)
关键词
药物性肝功能衰竭
临床特征
预后分析
Drug-induced liver failure
Clinical feature
Prognostic analysis
