药物性肝损伤临床特点分析及疗效观察

A clinical analysis and treatment of the drug- induced liver injur

目的探讨药物性肝病的临床特点及治疗方法。方法对解放军第102医院药物性肝损害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40．7％，其次为抗肿瘤药，占15．5％；临床以肝细胞型多见，占49．5％，胆汁淤积型占29．6％，混合型占20．9％；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ALT升高206例（100％）；ALP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 analysis the clinical characteristics and the treatment of drug- induced liver injury. Methods 206 patients with DILD 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 （40.7%）, and antineoplastic （ 15.5 % ） ;49.5 % was classified as hepatocellular type, 29.6% as cholestatic type, and 20.9 % 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% ）, ALP（52.4% ） and TD（26.2% ）. The patients were recowered in 165 patients, improved in 32 patients, and died in 2 patients. Gonelusiorl A variety of drugs can induce liver disease, we should discover the immediate and cure early.