阿莫西林-克拉维酸致肝损害的系统性综述

Liver Damage Caused by Amoxycillin-clavalanic Acid-A Systematic Review

目的：综合阿莫西林－克拉维酸致肝损害的文献资料，材料与方法：系统进行检索，并筛选和分析后再进行综述，结果：在检索的４１篇文献中，全文２１篇，英文摘要６篇，多为病例或系列病例报道。病例中，男性多于女性，５５岁以上占大多数，阿莫西林－克拉维酸的日剂量多为１．５±０．３７５ｇ，疗程１２ｄ左右，潜伏期３０ｄ左右，症状体征无特殊性，肝功能检查多项明显异常，病理学检查主要表现为中央区胆汁郁积，汇管区炎性浸润，

Chinese and English literature on liver damage caused by amoxycillin-clavalanic acid were retrieved and analyzed. 41 related articles were found, which appeared in 20 periodicals and magazines published in over 5 languages and in more than 10 countries. Among the 27 articles, 21 were full-text articles and 6 were English abstracts. Most of them were case reports. Of the cases reported, males outnumbered females and most patients were over 55 years old. The daily dosage of amoxycillin-calavalanic acid was 1.5±0.375g and treatment time was 12 days on average. The incubation time was about 30 days. The diseases showed no characteristic signs and symptoms. Liver function test imparted abnormalities of many items and pathological esamination revealed central congestion of bile and inflammatory infiltration of portal area. The disease course lasted for about 2 months. The patients usually had good prognosis after withdrawal of amoxy-cillin-clavalanic acid. Most diagnosis in the literature are reliable. The main culprit of the liver damage was clavalanic acid with the incidence being 1/100 000 and 1/56 000 of the patients were reported. The mechanism may have some to do with specific immune reactions. Our analysis showed that amoxycillin-clavalanic acid could cause liver damage.