847例住院精神病患者肝功能异常的调查研究

Investigation of abnormal liver function in 847 inpatients with psychiatric disorder

目的研究基层医院住院精神病患者的肝功能异常发生及转归情况。方法以本院2015年1月至2016年12月期间住院的847例精神病患者为对象,回顾性分析患者肝功能异常的发生率、病因、相应致肝损伤药物及其转归。结果住院精神病患者的肝功能异常发生率为42.50%,其中抗精神病药物所致肝损伤的发生率为26.33%。相关致肝损伤药物排序分别为氯丙嗪>丙戊酸>氯氮平>奥氮平>奋乃静>利培酮>喹硫平>阿立哌唑。经及时保肝药物对症治疗或调整相应精神科药物治疗方案后,84.75%的患者其肝功能指标在3个月内恢复至正常范围。结论住院精神病患者肝功能异常尤其是药物性肝损伤的发生率较高,及时对症治疗或调整相应致肝损伤药物治疗方案后预后相对较好。

Objective To study the occurrence and prognosis of abnormal liver function in the inpatients with psychiatric disorder.Methods A total of 847 psychiatric inpatients treated in Mental Health Center of Shanghai Jinshan District from January 2015 to December 2016 were included in this study.A retrospective study was conducted to analyze the incidence of abnormal liver function,etiology,liver damage caused by antipsychotic drugs and their prognosis.Results The incidence of abnormal liver function was 42.50% in psychiatric inpatients.The incidence of liver damage caused by antipsychotic drugs was 26.33%.The ranking of related liver damage drug was chlorpromazine>valproic acid>clozapine>olanzapine>perphenazine>risperidone>quetiapine>aripiprazole.After timely symptomatic treatment or adjusting the corresponding antipsychotic drugs treatment regimen,84.75% of the patients were recovered to normal range within 3 months.Conclusion The incidence of abnormal liver function,especially drug-induced liver damage,is higher in psychiatric inpatients.Timely symptomatic treatment or the adjustment of corresponding liver damage drugs treatment has a relatively good prognosis.