药物性肝损害文献分析

Analysis of the literature on druy induced-hepatic injury

目的:调查了解引起肝损害的药物品种,给药途径,药物性肝损害的临床分类,患者性别及年龄,临床表现及治疗措施等情况,以期为临床用药提供参考。方法:以"肝损害""不良反应"为关键词检索相关数据库2001年至2011年文献,从中筛选出3344例药物致肝损害病例进行回顾性分析和探讨。结果:本次检索共命中相关文献136篇,其中综合病例报道37篇,个案报道99篇,累计病例3344例。药物性肝损害的最常见给药途径是口服给药,为77.96%。临床表现多为黄疸,乏力,消化系统症状等非特异性症状。肝损害的临床分类中以肝细胞损害型最为常见。药物引起肝损害的病例数前五位为抗结核药、中药及中成药、抗生素、抗肿瘤药、解热镇痛抗炎药。结论:引起肝损害的药物种类繁多,由于药物性肝损害的临床表现无特异性,易误诊及漏诊,应引起临床高度重视。

Objective： To investigate drug-induced hepatic injury for promoting clinical rational use of drugs. Methods： With ＂hepatic injury＂ and ＂adverse reactions＂ as keywords, drug-induced hepatic injury cases were retrieved from relevant databases from 2001 to 2011, analyzed and discussed. Results： 136 papers including 37 Summary reports, and 99 individual case reports with a total of 3344 cases of drug-induced hepatic injury were retrieved. 77.96% cases were via oral administration.Most clinical manifestations were jaundice, lassitude, and nonspecifie digestive syste system. Liver cell damage was the most common type.The top five drugs that caused liver injury were TB drugs, traditional Chinese medicine, antibiotics, antineoplastics,antipyretic analgesics and anti-inflammatory drugs. Conclusion： A great variety of drugs can induce liver injury.Because of its non-specific clinical manifestation, and the possibility of its misdiagnosis and missed diagnosis, great importance should be at- tached to the monitoring and rational use of the related drugs.