中国药物警戒 ›› 2018, Vol. 15 ›› Issue (11): 677-681.

• 安全性评价与合理用药 • 上一篇    下一篇

我院106例药源性肝损伤患者的临床特征分析

闫荟羽1, 史吉平2, 毛丽超1, 张四喜1, *   

  1. 1 吉林大学第一医院药学部,吉林 长春 130021;
    2 吉林大学药学院,吉林关键词：药源性肝损伤;不良反应;回顾性分析
  • 收稿日期:2019-01-09 修回日期:2019-01-09 出版日期:2018-11-20 发布日期:2019-01-09
  • 通讯作者: 张四喜,男,硕士,副主任药师,医院药学管理与临床药学。E-mail：sixi100@sohu.com
  • 作者简介:闫荟羽,女,硕士,主管药师,临床药学。

Clinical Characteristics of 106 Cases of Drug-Induced Liver Injury in Our Hospital

YAN Huiyu1,SHI Jiping2,MAO Lichao1,ZHANG Sixi1*   

  1. 1 Pharmacy Department of The First Hospital of Jilin University, Jilin Changchun 130021, China;
    2 Pharmacy College of Jilin University, Jilin Changchun 130021, China
  • Received:2019-01-09 Revised:2019-01-09 Online:2018-11-20 Published:2019-01-09

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摘要： 目的 探讨药源性肝损伤（DILI）临床特点及发生规律，降低药品不良反应发生率，促进临床合理用药。方法 我院2015年1月- 2017年12月发生的106例药源性肝损伤患者的年龄、性别、发病时间、用药品种、临床特征等资料进行回顾性分析，使用SPSS 22.0对数据进行统计学分析，计数资料用百分比表示，计量资料用均数±标准差（ヌ±s）表示，多组均数比较采用单因素方差分析。结果 男性40例，女性66例，平均年龄（48.12±14.00）岁；药物按构成比依次为是中药、抗肿瘤药、非甾体抗炎药和抗感染药物；开始用药至起病多在12周内，特征以身目黄染、尿液颜色加深、乏力、食欲减退、恶心、呕吐、腹胀等为主，18.4%无症状；临床分型以肝细胞损伤型最多（41.51%）、混合型（28.30%）次之，胆汁淤积型（15.09%）和肝生化学异常（15.09%）最少；50例病理结果均倾向药物性肝损伤。结论 药源性肝损伤临床特征不特异，易漏诊和误诊，但大多数预后较好。临床医生应该加强对DILI的警惕，根据其病因、临床特征，早期识别、及时停药并给予适当保肝治疗。

关键词: 药源性肝损伤, 不良反应, 回顾性分析

Abstract: Objective To investigate the clinical characteristics and occurrence of drug-induced liver injury (DILI), so as to reduce the incidence of adverse drug reactions and promote the rational use of drugs. Methods A retrospective analysis was performed on 106 patients with drug-induced liver injury in our hospital from January 2015 to December 2017. The data were statistically analyzed by SPSS 22.0. The count data expressed as a percentage, measurement data with mean ± standard deviation (ヌ±s), multiple groups were compared using single factor analysis of variance. Results There were 40 males and 66 females with a mean age of (48.12±14.00) years involved. The drugs were orderly ranked traditional Chinese medicine, antineoplastic agents, NSAIDs and anti-infective drugs according to their constituent ratios. The time to onset was within 12 weeks with characteristics of yellow skin, darker urine, decreased appetite, nausea, vomiting and abdominal distension, while 18.4% of patients were asymptomatic. The types of injury were hepatocellular injury (41.51%), mixed type (28.30%) followed by cholestasis type (15.09%) and liver biochemical abnormality (15.09%). The pathological results of 50 patients tended to be drug-induced liver injury.Conclusion Clinical characteristics of drug-induced liver injury were not specific and easy to misdiagnose. However, most of the prognoses were good. Clinicians should strengthen their vigilance against DILI and carry out early identification, timely withdraw suspected drugs and apply appropriate hepatoprotective therapy based on etiology and clinical features.

Key words: drug-induced liver injury, adverse reactions, retrospective analysis

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