老年糖尿病患者药物性肝损伤分型及预后分析

A study on the classification and prognosis of Drug-induced liver injury in aged diabetes

目的研究分析不同药物致老年糖尿病患者药物性肝损伤分型及预后。方法 2012年1月至2014年12月期间收集老年糖尿病合并药物性肝损伤患者192例,根据肝功能指标进行分型,并追踪分析其预后转归。结果本组老年糖尿病患者药物性肝损伤肝细胞型为47.7%(91/192),胆汁淤积型为32.3%(62/192),混合型为20.3%(39/192)。所有患者在确诊后立即停用可疑损害肝脏药物,并予护肝、降酶、消炎利胆等治疗,多数患者预后良好,治愈率92.7%(178/192),死亡率2.6%(5/192)。结论老年糖尿病患者药物性肝损伤以肝细胞型为主,预后尚可,但是起病隐匿,临床仍需重视。

Objectives To investigate the classification and prognosis of drug-induced liver injury （DILI） in aged diabetes. Methods From January 2012 to December 2014,192 cases of drug-induced liver injury in aged diabetes were recruited and the subtypes of drug-induced liver injury according to liver function test were executed and analyzed. Also the prognosis indexes such as cure rate and mortality was analyzed. Results 91 （47.7%） ,62 （32. 3% ） , 39 （20. 3% ）cases were designated hepatocellnlar, chol- estetic and mixed subtype each. Most of the cases（ 85.55% ）recovered in 8 weekss after withdrawal of the causative drug and proper supportive therapy though 8 cases （4. 2% ）developed into chronic DILl and 5 cases （2. 6% ） resulted in unfavorable ending. Conclu- sions Drug-induced liver injury（DILI） in aged diabetes majors in hepatocellular subtype, owns not bad prognosis with a hiding on- set which needs clinical attention.