[1]马 帅,李家斌.药物性肝损伤的临床分析[J].医学信息,2019,32(03):128-130.[doi:10.3969/j.issn.1006-1959.2019.03.041]
　MA Shuai,LI Jia-bin.Clinical Analysis of Drug-induced Liver Injury[J].Journal of Medical Information,2019,32(03):128-130.[doi:10.3969/j.issn.1006-1959.2019.03.041]
点击复制

药物性肝损伤的临床分析()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年03期
页码:
128-130
栏目:
调查分析
出版日期:
2019-02-01

文章信息/Info

Title:
Clinical Analysis of Drug-induced Liver Injury
文章编号:
1006-1959（2019）03-0128-03
作者:
马 帅1; 李家斌2
（安徽医科大学第一附属医院全科医学科1，感染科2，安徽 合肥 230000）
Author(s):
MA Shuai1; LI Jia-bin2
(Department of General Medicine1,Department of Infectious Diseases2,the First Affiliated Hospital of Anhui Medical University,Hefei 230000,Anhui,China)
关键词:
药物性肝损伤; 中药; 西药; 肝细胞性肝炎; 病理
Keywords:
Drug-induced liver injury; Traditional Chinese medicine; Western medicine;  Hepatocellular hepatitis; Pathology
分类号:
R595.3
DOI:
10.3969/j.issn.1006-1959.2019.03.041
文献标志码:
A
摘要:
目的 通过分析DILI的临床和病理特征及相关的药物类型，为患者和医疗保健人员提供药物安全信息。方法 回顾性分析2016年6月~2018年6月我院收治的126例DILI患者的临床资料，分析病因类别、临床和病理特征。结果 中药被列为126例DILI的首要原因，占54.14%。引起肝损伤中药成分大多数为何首乌、土三七，以及用于治疗骨病，关节病，皮肤病，胃病，白细胞减少症，脱发和妇科疾病的复方制剂等。西药是DILI的另一个主要原因，其中抗结核药物是DILI最主要的原因（22.22%），其次是抗生素（7.83%）和抗甲状腺药物（3.97%）。无论中草药还是西药诱导的DILI，肝细胞性肝炎在DILI中都很普遍。结论 应明确用药风险并合理用药，以减少DILI的发生。对于来源不明的肝损伤患者，建议进行肝组织病理检查以进一步诊断。
Abstract:
Objective To provide drug safety information for patients and health care staff by analyzing the clinical and pathological features of DILI and related drug types. Methods The clinical data of 126 patients with DILI admitted to our hospital from June 2016 to June 2018 were retrospectively analyzed. The etiology, clinical and pathological features were analyzed. Results Chinese medicine was listed as the primary cause of 126 cases of DILI, accounting for 54.14%. Most of the traditional Chinese medicine ingredients causing liver damage are Heshouwu, Tusanqi, and compound preparations for treating bone diseases, joint diseases, skin diseases, stomach diseases, leukopenia, hair loss and gynecological diseases. Western medicine was another major cause of DILI, among which anti-tuberculosis drugs were the most important cause of DILI (22.22%), antibiotics (7.83%) and anti-thyroid drugs (3.97%) were also one of the main causes of DILI. Regardless of Chinese herbal medicine or western medicine-induced DILI, hepatocellular hepatitis was common in DILI. Conclusion The risk of medication should be clarified and drug use should be rational to reduce the occurrence of DILI. For patients with liver injury of unknown origin, pathological examination of liver tissue is recommended for further diagnosis.

参考文献/References:


[1]Jakab L.The liver and the immune system[J].Orv Hetil,2015,156(30):1203-1213.
[2]Chughay MF,Kramer N,Spearman CW,et al.N-acetylcysteine for non-paracetamol drug-induced liver injury :A systematic review[J].Br J Clin Pharmacol,2016,4(1):1021-1029.
[3]郝坤艳,于乐成,何长俊,等.基于Roussel Uclaf因果关系评估量表的药物性肝损伤140例诊治分析[J].中华肝脏病杂志,2014,22(12):82-85.
[4]Tailor A,Faulkner L,Naisbitt DJ,et al.The chemical, genetic andimmunological basis of idiosyncratic drug-induced liver injury[J].Hum Exp Toxicol,2015,34(12):1310-1317.
[5]Mcgill MR,Du K,Weemhoff JL,et al.Critical review of resveratrol in xenobiotic-induced hepatotoxicity[J].Food and Chemical Toxicology,2015,86(11):309-318.
[6]Bj?觟rnsson ES,Bergmann OM,Bj?觟rnsson HK,et al.Incidence, presentation, and outcomes in patients with drug-induced liver injury in the general population of Iceland[J].Gastroenterology,2013,144(7):1419-1425.
[7]Chalasani NP,Hayashi PH,Bonkovsky HL,et al.ACG Clinical Guideline:the diagnosis and management of idiosyncratic drug-induced liver injury[J].Am J Gastroenterol,2014,109(7):950-966.
[8]Chen M,Suzuki A,Borlak J,et al.Drug-induced liver injury:interactions between drug properties and host factors[J].J Hepatol,2015,63(2):503-514.
[9]艾莉莎,孙昳,梁运光.83例药物性肝损伤的临床分析[J].中国医药指南,2015,13(9):89-90.

相似文献/References:

[1]邱梦君,郑国荣.大黄、黄连、黄芩联合三联序贯治疗Hp感染的疗效分析[J].医学信息,2018,31(06):137.[doi:10.3969/j.issn.1006-1959.2018.06.047]
　QIU Meng-jun,ZHENG Guo-rong.Curative Effect Analysis of Sequential Treatment of Hp Infection by Rhubarb,Coptis Chinensis and Radix Scutellariae[J].Journal of Medical Information,2018,31(03):137.[doi:10.3969/j.issn.1006-1959.2018.06.047]
[2]黄幼玲.中药配合鹿瓜多肽治疗股骨头坏死临床效果观察[J].医学信息,2018,31(06):141.[doi:10.3969/j.issn.1006-1959.2018.06.049]
　HUANG You-ling.Clinical Observation on Treatment of Femoral Head Necrosis with Chinese Medicine Combined with Lugua Polypeptide[J].Journal of Medical Information,2018,31(03):141.[doi:10.3969/j.issn.1006-1959.2018.06.049]
[3]赵一丹,杨 静.夏枯草主要化学成分抗肺癌作用机制研究进展[J].医学信息,2022,35(09):42.[doi:10.3969/j.issn.1006-1959.2022.09.010]
　ZHAO Yi-dan,YANG Jing.Research Progress on Anti-lung Cancer Mechanism of Main Chemical Constituents of Spica Prunellae[J].Journal of Medical Information,2022,35(03):42.[doi:10.3969/j.issn.1006-1959.2022.09.010]
[4]李 扬,冯 旭,宋 舸,等.中药药性的研究方法进展[J].医学信息,2018,31(13):38.[doi:10.3969/j.issn.1006-1959.2018.13.012]
　LI Yang,FENG Xu,SONG GE,et al.Progress in Research Methods of Medicinal Properties of Traditional Chinese Medicine[J].Journal of Medical Information,2018,31(03):38.[doi:10.3969/j.issn.1006-1959.2018.13.012]
[5]王慧明,卓春萍,王庆雷,等.钢板内固定术联合中药煎服治疗胫骨平台骨折的 临床疗效观察[J].医学信息,2018,31(14):110.[doi:10.3969/j.issn.1006-1959.2018.14.032]
　WANG Hui-ming,ZHUO Chun-ping,WANG Qing-lei,et al.Clinical Observation on Treatment of Fracture of Tibial Plateau with Plate Internal Fixation Combined with Traditional Chinese Medicine Decoction[J].Journal of Medical Information,2018,31(03):110.[doi:10.3969/j.issn.1006-1959.2018.14.032]
[6]郑 瑜.人血白蛋白联合中药治疗卵巢过度刺激综合征患者的疗效观察[J].医学信息,2019,32(04):151.[doi:10.3969/j.issn.1006-1959.2019.04.049]
　ZHENG Yu.Therapeutic Effect of Human Serum Albumin Combined with Traditional Chinese Medicine on Patients with Ovarian Hyperstimulation Syndrome[J].Journal of Medical Information,2019,32(03):151.[doi:10.3969/j.issn.1006-1959.2019.04.049]
[7]吴 迪,柴仲秋,周 冰.靶向癌蛋白调控Warburg效应的中医药研究进展[J].医学信息,2022,35(13):42.[doi:10.3969/j.issn.1006-1959.2022.13.008]
　WU Di,CHAI Zhong-qiu,ZHOU Bing.Research Progress of Traditional Chinese Medicine Targeting Oncoproteins to Regulate Warburg Effect[J].Journal of Medical Information,2022,35(03):42.[doi:10.3969/j.issn.1006-1959.2022.13.008]
[8]陶 源,徐俊林,陈 超.《中医方剂大辞典》胃脘痛的用药规律分析[J].医学信息,2019,32(09):161.[doi:10.3969/j.issn.1006-1959.2019.09.054]
　TAO Yuan,XU Jun-lin,CHEN Chao.Analysis of the Law of Medication for Stomach Cramps in the Dictionary of Traditional Chinese Medicine Formula[J].Journal of Medical Information,2019,32(03):161.[doi:10.3969/j.issn.1006-1959.2019.09.054]
[9]江启煜,何晓华,刘秀峰,等.中药生物分子信息文献系统的研发与应用[J].医学信息,2019,32(15):10.[doi:10.3969/j.issn.1006-1959.2019.15.004]
　JIANG Qi-yu,HE Xiao-hua,LIU Xiu-feng,et al.Development and Application of Traditional Chinese Medicine Biomolecular Information Document System[J].Journal of Medical Information,2019,32(03):10.[doi:10.3969/j.issn.1006-1959.2019.15.004]
[10]詹淑华,赵慧姝,陈贵儒.预防性保肝治疗对老年初治肺结核患者肝损伤的影响研究[J].医学信息,2022,35(14):45.[doi:10.3969/j.issn.1006-1959.2022.14.009]
　ZHAN Shu-hua,ZHAO Hui-shu,CHEN Gui-ru.Effect of Preventive Liver Protection Therapy on Liver Injury in Elderly Patients with Pulmonary Tuberculosis[J].Journal of Medical Information,2022,35(03):45.[doi:10.3969/j.issn.1006-1959.2022.14.009]

更新日期/Last Update: 2019-02-25