药物性肝炎344例临床分析

Clinical analysis of 344 cases of drug-induced hepatitis

目的:探讨药物性肝炎的病因、临床特点及治疗。方法:回顾性分析我院2004～2009年收治的药物性肝炎344例的临床资料,通过对基础病、用药种类、临床表现、实验室检查及临床转归等总结其发病规律及特点。结果:引起药物性肝炎的基础病主要为肺结核、糖尿病、甲亢、风湿性关节炎、精神性疾病等;引发药物性肝炎的药物种类较多,主要以中药、抗结核药、抗生素为主;临床表现乏力、纳差、尿黄、眼黄、身黄、恶心、皮肤瘙痒等;停药及保肝治疗后治愈率93.9%,肝衰竭发生率6.1%,死亡率0.9%,发生肝衰竭以抗结核药为主,其次为中药。人工肝支持治疗药物性肝炎,可明显降低病死率,缩短病程。结论:应高度重视药物性肝炎,注意了解药物的成分、适应证、禁忌证,影响药物性肝炎的因素主要有用药种类、用药时间及是否合并乙肝等。

Objective：To investigate the causes,clinical features and treatment of drug-induced hepatitis for further enhancing the understanding of drug-induced hepatitis and preventing its occurrence.Methods：The retrospective analysis was performed on the clinical data of 344 cases of drug-induced hepatitis treated in our hospital from 2004 to 2009,including basic diseases,drug types,clinical manifestations,laboratory findings and clinical outcome.To investigate the rules and characteristics of onset.Results：The basic diseases causing drug hepatitis were mainly tuberculosis disease,diabetes,hyperthyroidism,rheumatoid arthritis,mental disorders,etc.;there were many categories of drugs causing drug-induced hepatitis,which mainly were the traditional Chinese medicines,anti-TB drugs and antibiotics;the clinical manifestations were fatigue,anorexia,yellow urine,yellow body,yellow eyes,nausea and skin itching;after drug withdrawal and hepatoprotective therapy,the cure rate could reach to 93.9%,the incidence of liver failure was 6.1% with the mortality of 0.9%,which was mainly caused by anti-TB drugs,followed by the traditional Chinese medicines.Artificial liver support for treating drug-induced hepatitis could significantly reduce the mortality and shorten the disease course.Conclusion：We should attach great importance to drug-induced hepatitis,and pay attention to the ingredients,indications and contraindications.The factors affecting drug-induced hepatitis are mainly categories of drugs,medication time and complicating hepatitis B.