156例药物性肝损害文献分析

Drug-Induced Hepatic Injury:Literature Analysis of 156 Cases

目的:探讨药物性肝损害的特点和临床表现,为临床用药提供参考。方法:对最近3年来国内药物性肝损害的文献报道进行整理、分类统计和分析。结果:156例报告中,药物性肝损害发生率最高的是≥60岁的老年患者,共60例,占38.46%;发生药物性肝损害的最常见给药途径是口服给药,共92例,占58.97%;药物性肝损害报告共涉及13类61种药物,排序前3位依次为抗感染药(54/156,34.62%)、心脑血管药物(28/156,17.95%)、中枢神经系统用药(20/156,12.8%)。结论:引起药物性肝损害的药物种类繁多,由于药物性肝损害临床表现无特异性,易误诊及漏诊,在有基础肝脏疾病的患者中更为常见,应加强对相关药物的监测,提高合理用药水平。

OBJECTIVE：To discuss the characteristics and clinical manifestation of drug-induced hepatic injury for clinical reference about drug use.METHODS： The drug-induced hepatic injury cases reported in literature over the past 3 years were collected,classified and analyzed statistically.RESULTS： Of the 156 cases,the patients aged ≥60 took the lead,with 60 cases（38.46%）;92（58.97%） were induced via oral administration.A total of 13 categories including 61 drugs were involved,with anti-infective drugs（54/156,34.62%）,cardio-cerebrovascular drugs（28/156,17.95%） and central nerve system drugs（20/156,12.8%） leading the first 3 places.CONCLUSION： A great variety of drugs can induce liver injury.The non-specificity in clinical manifestation of drug-induced liver injury,the possibility of its misdiagnosis and missed diagnosis and the fact that it is more common in patients with basic liver disease,great importance should be attached to the monitoring on the related drugs to improve rational drug use level.