胆汁淤积型药物性肝病92例临床研究

Retrospective clinical analysis of 92 cases of cholestasis-type drug-induced liver disease

目的分析总结近年来本院发生胆汁淤积型药物性肝病的病因及熊去氧胆酸(UDCA)治疗本病的疗效。方法回顾分析近3年来各种药物致胆汁淤积型药物性肝病92例,探讨胆汁淤积型药物性肝病的病因及临床特点;比较分析了采用保肝降酶加UDCA(750 mg/d)治疗(A组=62例)及未应用UDCA治疗(B组=30例)的恢复情况,观察2组间临床症状、体征的改善和肝功能生化指标。结果引起胆汁淤积型药物性肝病的药物主要有中草药(22.83%)、抗肿瘤药(17.39%)、抗结核药(16.30%)和抗生素(13.04%)。经治疗后2组患者临床症状、体征均有明显改善;治疗前后的TBil、DBil、GGT差值两组比较差异有统计学意义(P=0.0002,P=0.0007,P=0.0009)。结论引起胆汁淤积型药物性肝病的病因是多样的,加用UDCA治疗胆汁淤积型药物性肝病疗效显著。

Objective： To investigate the etiology and incidence of cholestasis-type drug-induced liver disease and to observe the efficacy of ursodeoxycholic acid（UDCA）in the treatment in our hospital.Methods： We investigated the causes of 92 cases and incidence of cholestasis-type drug-induced liver disease caused by some medicines in 92 cases using retrospective methods.The 92 cases were divided into the two groups： one of the treatment with liver-protecting and transaminase lowering treatment together with UDCA（750mg/d）treatment（group A）,and another group without UDCA（group B）.Comparison between two groups was analyzed in clinical signs,symptoms,and biochemical indicators of liver function.Results： The cholestatic liver disease was mainly caused by the tranditional Chinese drugs（22.83%）,anti-tuberculous（16.30%）antineoplasticdrugs（17.39%）and antibiotics（13.04%）.In the clinical signs and symptoms,two groups are improved more significantly after treatment than before.In the biochemical aspects of liver function TBil,DBil,GGT,the difference of these indictors before and after treatment in group A was significantily better than that in group B（P=0.0002,P=0.0007and P=0.0009,respectively）.Conclusion： The drug map which can induce drug-related intrahepatic is very broad.UDCA is effective in the treatment of the cholestatic drug induced liver disease.