中国药物警戒 ›› 2025, Vol. 22 ›› Issue (5): 528-531.
DOI: 10.19803/j.1672-8629.20250037

• 免疫细胞介导的药物性肝损伤研究专栏 • 上一篇    下一篇

妊娠期常用药物肝损伤研究进展

曹卫平1, 张世超2, 倪霞1, 谢冰1, 王欣之3,*, 邢孟韬4#   

  1. 1镇江市妇幼保健院产科,江苏 镇江 212001;
    2西交利物浦大学慧湖药学院,江苏 苏州 215123;
    3中国药科大学多靶标天然药物全国重点实验室新药筛选与药效评价中心,江苏 南京 210009;
    4中国药科大学药学院药理系,江苏 南京 211198
  • 收稿日期:2025-01-16 出版日期:2025-05-15 发布日期:2025-05-19
  • 通讯作者: *王欣之,女,副研究员·博导,分子药理学与毒理学。E-mai: wangxz@cpu.edu.cn;#为共同通信作者。
  • 作者简介:曹卫平,女,主任护师·硕导,妊娠期并发症的预防。
  • 基金资助:
    国家自然科学基金资助项目（82274200、82073948、81703626）; 镇江市妇产疾病临床医学研究中心开放性课题（SS2022003-KFB03）; 镇江市社会发展项目（SH2023093）

Research Progress in Liver Injury Caused by Drugs Commonly Used during Pregnancy

CAO Weiping1, ZHANG Shichao2, NI Xia1, XIE Bing1, WANG Xinzhi3,*, XING Mengtao4#   

  1. 1Department of Obstetrics, Maternity and Child Health Hospital of Zhenjiang, Zhenjiang Jiangsu 212001, China;
    2Huihu School of Pharmacy, Xi’an Jiaotong Liverpool University, Suzhou Jiangsu 215123, China;
    3State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing Jiangsu 210009, China;
    4Department of Pharmacology, China Pharmaceutical University, Nanjing Jiangsu 211198, China
  • Received:2025-01-16 Online:2025-05-15 Published:2025-05-19

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摘要： 目的 总结妊娠期药物性肝损伤（Drug-Induced Liver Injury,DILI）的分类与机制、诊断方法和管理、引起肝损伤的常用药物等,以期为妊娠期妇女安全用药提供参考,加强妊娠期用药警戒。方法 检索PubMed、The Cochrane Library、The Web of Science、中国知网、CBM数据库,对妊娠期常用药物肝损伤相关文献整理、分析,并提取妊娠期常用药物肝损伤内容。结果 妊娠期DILI主要分为直接型、间接型和特异质型3种类型,妊娠期主要以特异质型为主;DILI是一种排除性诊断,通常只在排除肝炎的其他原因后才能做出诊断;妊娠期DILI的管理与非妊娠期人群类似;引起妊娠期DILI的常用药物有降压药、抗甲状腺药、抗逆转录病毒和抗结核药物以及抗生素等。结论 妊娠期DILI研究报道较少,现有文献大多以病例报道的形式出现,发病率不确定、诊断较困难,管理具有一定的挑战性,需要提高妊娠期安全用药的识别与警戒,保障患者用药安全。

关键词: 妊娠期药物肝损伤, 拉贝洛尔, 丙基硫氧嘧啶, 分类与机制, 诊断和管理

Abstract: Objective To provide an overview of the classification, mechanisms, diagnostic methods, and management of drug-induced liver injury(DILI) during pregnancy in order to ensure pharmacovigilance during pregnancy. Methods Such databases as PubMed, the Cochrane Library, the Web of Science, CNKI and CBM were searched for literature related to DILI during pregnancy. Results The incidence of DILI during pregnancy fluctuated. Liver injury was primarily divided into three types: direct, indirect or specific, with the last type dominating during pregnancy. DILI still relied on the diagnosis of exclusion, usually made only after other causes of hepatitis were ruled out. DILI during pregnancy was handled in the same way as in non-pregnant populations. The commonly used drugs that could cause DILI during pregnancy included antihypertensive drugs, anti-thyroid drugs, antiretroviral and anti-tuberculosis drugs as well as antibiotics. Conclusion Research reports on DILI during pregnancy are lacking. Moreover, most of the literature currently available is case reports. The incidence of this disease varies, diagnosis is difficult, and management is challenging. Pharmacovigilance during pregnancy has to be upgraded to ensure the safety of patients.

Key words: Drug-Induced Liver Injury during Pregnancy, Labetalol, Propylthiouracil, Classification and Mechanism, Diagnosis and Management

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