何首乌致肝损害13例临床分析

Clinical analysis of 13 patients with liver disease induced polygonum multiflorum thumb.

目的回顾性分析何首鸟所致肝损害13例临床特征。方法收集2005年4月．2007年7月收治的何首鸟所致的肝损害13例，详细记录每倒患者服药史、临床表现、肝功能、凝血酶原时间、肝炎标志物检查、自身免疫相关检查、影像学检查、治疗经过及预后。结果何首乌所致的药物性肝损害潜伏期为7-30d，主要临床表现为乏力、纳差、皮肤巩膜黄染，2例伴有皮肤瘙痒，肝大5例，脾大3例，腹水1例；肝功能酶学明显升高，以ALT升高为主，92．3％（12／13）伴有黄疸，以直接胆红素升高为主，重症药物性肝损害2例。结论何首鸟所致药物性肝损害服药史较隐蔽，多数伴有黄疸，临床分型为混合型，本病预后较好。

Objective To investigate clinical character of 13 patients with Liver disease induced polygonum maltiflorum thumb retrospectively .Methods The every patient＇s data, including administration history, clinical manifestations, liver function, prothrombin time, hepatitis virus markers, examination of autoimmunlty disease, imaging outcome, treatment and prognosis, were recorded in detail from May 2005 to July 2007. Results The incubation was 7 ~ 30 days. The most patients showed hypodynamia,decreased food appetite, skin and icteric sclera ： 2 patients of them accompanied itch of skin. hepatauxe and splenomegaly were 5 patients and 3 patients respectively. 1 patiet showed ascites. The aminolransferase of all patients raised up obviously. ALT was higher than AST. Jaundice was observed by 92. 3 % （ 12/13）and direct bilirubin raised more than indirect bilirubin, severe liver disease induced drug occurred in 2 patients. Conclusion It is difficult to discover oral administration history of liver disease induced polygonum multiflorum thumb. Clinical classification of the disease is mixed type. In spite of occurring mostly jaundice, its prognosis was good.