药物性肝损害临床特点及治疗分析

Clinical analysis and treatment of the drug-induced liver injure

目的 探讨药物性肝损害的临床特点及治疗方法.方法 对2000-2008年我院收治的药物性肝损害206例患者的临床资料进行回顾性分析.结果 引起肝损害的药物种类繁多,以抗生素（包括抗结核药物）为最多,占40.3%（83/206）,其次为抗肿瘤药,占15.5%（32/206）.临床以肝细胞型多见,占49.5%（102/206）,胆汁淤积型占29.6%（61/206）,混合型占20.9%（43/206）.主要临床表现有纳差、乏力、黄疸、上腹部不适、皮疹、发热.实验室检查丙氨酸氨基转移酶升高206例（100.0%）;碱性磷酸酶升高108例（52.4%）;总胆红素升高54例（26.2%）.临床治愈165例,好转32例,自动出院7例,死亡2例.结论 引起药物性肝损害的药物种类很多,应及早发现及时治疗.

Objective To analyse the clinical characteristics and the treatment of drug-induced liver injury.Methods Two hundred and six patients with drug-induced liver injury admitted to our hospital from 2000 to 2008 were reviewed retrospectively.Results A variety of drugs were involved in causing liver disease.The common offending agents were antimicrobial agents（40.3%,83/206）,and antineoplastic（15.5%,32/206）;49.5%（102/206） was classified as hepatocellular type,29.6%（61/206） as cholestatic type,and 20.9%（43/206） as mixed type.The main clinical manifestations were fatigue,jaundice,anorexia,epigastrium uncomfortable,rash,fever.The laboratory tests of liver functions showed increased levels of ALT （100.0%）,ALP （52.4%,108/206） and TD（26.2%,54/206）.165 patients recovered,32 patients improved,and 2 patients died.Conclusions A variety of drugs can induce liver disease.