摘要
目的探讨高龄老人药物性肝损伤(DILI)的病因及临床特点。方法回顾性分析海军第905医院老年医学科(原第八五医院干部病房)及长海医院老年医学科(长海医院及原海军411医院干部病房)2014年6月至2020年12月诊断为DILI的高龄患者162例,采用RUCAM量表评价药物与肝损伤的相关性,分析引起DILI的药物类型、临床分型及特点。结果本组患者年龄最小68岁,最高龄为96岁,平均年龄为91.2岁,引起DILI的前三位药物分别是中草药及中成药68例(41.98%),抗感染药物21例(12.96%)及心血管药物13例(8.02%),RUCAM分值均≥3,临床表现无明显特异性。胆汁淤积型76例,最常见,占46.91%,肝细胞损伤型48例,占29.63%;混合型38例,占23.46%。严重程度以1级为主75例(46.29%);2级53例(32.72%);3级22例(13.58%);4级12例(7.41%)。结论本研究中,高龄患者引起DILI的最常见原因是中药,应引起高度重视,临床表现无特异性,以胆汁淤积型多见,早期发现预后较好。
Objective To investigate the etiology and clinical features of elderly patients with drug-induced liver injury(DILI).Methods A total of 162 patients with DILI admitted to our hospital from June 2014 to December 2020 were selected,and their clinical data were retrospectively analyzed.The Roussel Uclaf Causality Assessment Method(RUCAM)was used to evaluate the relationship between drugs and liver injury.The suspected drugs related to DILI,the clinical manifestations and clinical features of DILI were also analyzed.Results The youngest patient was 68 years old and the oldest was 96,the average age was 91.2.The drugs most likely to induce DILI were Chinese herbal medicine and Chinese patent medicine(68 cases,41.98%),antibiotic(21 cases,12.96%)and cardiovascular drugs(13 cases,8.02%),the RUCAM grades were all more than 3,and there was no significant difference in clinical manifestations among the patients with DILI induced by the three drugs.The numbers of cholestatic injury type,hepatocellular injury type and mixed injury type were 76(46.91%),48(29.63%),38(23.46%),respectively.The proportion of severity grade 1,2,3 and 4 were 46.29%,32.72%,13.58%,7.41%respectively.Conclusion In the study,we find that traditional Chinese medicine is the main cause of DILI in elder patients,which is worthy of high attention.Clinical manifestations are not significantly different.The most common type is cholestatic DILI.Early intervention can improve the prognosis of patients.
作者
任慧琼
姚均迪
赵红信
鲁进宇
吴珑芝
REN Hui-qiong;YAO Jun-di;ZHAO Hong-xin;LU Jin-yu;WU Long-zhi(Department of Geriatrics,No.905 Hospital of Navy,Shanghai 200052,China;Department of Geriatrics,Changhai Hospital,Naval Military University,Shanghai 200433,China)
出处
《肝脏》
2021年第11期1276-1278,共3页
Chinese Hepatology
关键词
药物性肝损伤
高龄
临床特征
Drug-induced liver injury
Advanced age
Clinical features
