摘要
目的:对近5年药物性肝损伤(drug-induced liver injury,DILI)住院患者临床资料进行分析,探讨其预后影响因素。方法:回顾性分析某院近5年DILI住院患者临床资料,对患者年龄、性别、基础疾病、可疑药物种类及给药途径、临床表现、生化指标、临床分型、住院时间等因素进行单因素和多因素Logistic回归分析。结果:单因素分析结果显示,DILI患者职业、基础疾病、给药途径、初始ALP(碱性磷酸酶)、初始AST(天门冬氨酸氨基转移酶)、初始GGT(γ-谷氨酰转移酶)、初始TBIL(血清总胆红素)、ALT(丙氨酸氨基转移酶)峰值、ALP峰值、AST峰值、GGT峰值、TBIL峰值、ALB(白蛋白)峰值、WBC(白细胞)峰值、PLT(血小板)峰值对DILI患者预后的影响有统计学意义(P<0.05)。多因素Logistic回归分析表明,无业人员、中药、GGT峰值与患者预后呈负相关(P<0.05),呼吸及消化系统疾病、初始TBIL、初始GGT、ALB峰值、WBC峰值与患者预后呈正相关(P<0.05)。结论:无业人员和可疑用药为中药的患者预后较差,GGT峰值越高患者预后差。基础疾病为呼吸和消化系统疾病以及ALB峰值越高,患者预后好。
Objective:To analyze the clinical data of hospitalized patients with drug-induced liver injury(DILI)in recent 5 years and explore the prognostic factors.Methods:Clinical data of DILI inpatients in a hospital in the past 5 years were retrospectively analyzed,univariate and multivariate Logistic regression analysis were out on the factors of patients′age,gender,basic diseases,implicated drugs types and administration routes,clinical manifestations,biochemical indicators,clinical typing and length of stay.Results:The results of univariate analysis showed that occupation,basic disease,route of administration,initial ALP,initial AST,initial GGT,initial TBIL,ALT peak,ALP peak,AST peak,GGT peak,TBIL peak,ALB peak,WBC peak and PLT peak had statistically significant effects on the prognosis of DILI patients(P<0.05).Multivariate Logistic regression analysis showed that the unemployed,Chinese medicine,GGT peak were negatively correlated with prognosis of patients.(P<0.05).Respiratory and digestive diseases,initial TBIL,initial GGT,peak ALB and peak WBC were positively correlated with the prognosis of patients(P<0.05).Conclusion:When the unemployed and the implicated drugs are traditional Chinese medicine,the prognosis of the patients is poor.The GGT peak is higher,the prognosis of the patients is worse.When the underlying diseases are respiratory and digestive diseases and the ALB peak is higher,the prognosis is better.
作者
杨焕芝
徐艳琼
陈学平
李兴德
包金颖
方甜甜
张仲安
宋沧桑
YANG Huan-zhi;XU Yan-qiong;CHEN Xue-ping;LI Xing-de;BAO Jin-ying;FANG Tian-tian;ZHANG Zhong-an;SONG Cang-sang(Department of Pharmacy,Kuming Municipal First People′s Hospital,Yunnan Kunming 650034;College of Pharmacy,Kunming Medical University,Yunnan Kunming 650500;Department of gastroenterology,Kuming Municipal First People′s Hospital,Yunnan Kunming 650034)
出处
《中国药物评价》
2020年第3期222-227,共6页
Chinese Journal of Drug Evaluation
基金
云南省教育厅科学研究基金项目(2019J1297)
昆明市“科技保障民生发展计划”项目(2019KJJH080)。
关键词
药物性肝损伤
临床分析
预后
影响因素
Drug-induced liver injury
Clinical analysis
Prognosis
Influence factors
