解读ACG临床指南:“特异质型药物性肝损伤的诊断和管理”

Understanding of ACG Clinical Guideline: Diagnosis and Management of Idiosyncratic Drug-induced Liver Injury

2014年6月美国胃肠病学会(ACG)发布了全球首个关于药物性肝损伤(DILI)的临床指南:"特异质型药物性肝损伤的诊断和管理",其内容涵盖了特异质型DILI(IDILI)的危险因素、诊断、鉴别诊断和治疗等各方面,同时对草药和膳食补充剂(HDS)引起的DILI和慢性肝病患者的DILI问题进行了专门的讨论。指南对规范DILI的临床诊断和治疗具有重要价值,为IDILI患者提供了最佳管理建议。但目前DILI领域研究的证据质量较弱,临床医师应在指南框架指导下,充分考虑患者可能的个体化差异,作出最佳临床决策。

The American College of Gastroenterology（ ACG）released the first clinical guideline for drug-induced liver injury（ DILI）in June,2014：the diagnosis and management of idiosyncratic drug-induced liver injury（ IDILI）, which includes all aspects of IDILI,such as risk factors,diagnosis,differential diagnosis and treatment. The guideline discusses especially the issues on herbal and dietary supplements（ HDS）induced liver injury and DILI in patients with chronic liver disease. The guideline is of great value for standardizing the clinical diagnosis and treatment,providing the best recommendations for management of the patients with DILI. Since the evidence of research in the field of DILI is relatively weak at this moment,the clinicians should consider the possible individual difference of the patients under the frame of guideline for making the best clinical decision.