老年人药物性肝损伤患者94例临床分析

Clinical analysis of 94 cases of the elderly drug-induced liver injury

目的:探讨老年人药物性肝损伤患者的原因、分型和临床特点等,提高对老年人药物性肝损伤的认识。方法:回顾性分析94例老年药物性肝损伤患者的临床资料,对其发病率、病因、临床表现和预后等指标进行综合评价,总结老年人药物性肝损伤患者的临床特点。结果:肝损害患者平均年龄为70.37±8.46岁。引起老年人药物性肝损的药物排名前3位的是:抗结核药(42.55%)、中药和中成药(20.21%)和降血脂药(10.64%)。药物性肝损类型分别为:肝细胞型61例(64.89%)、胆汁淤积型24例(25.53%)和混合型9例(9.58%)。肝损伤程度:0级无,1级11例(11.70%),2级32例(34.04%),3级49例(52.13%),4级2例(2.13%),5级无。中度和重度肝损伤男女性别比较无显著差异。结论:老年人药物性肝损伤患者的防治应得到足够的重视。

Objective： To investigate the causes,classification,clinical characteristics of drug-induced liver injury in the elderly in order to improve the understanding of drug-induced liver injury among the elderly people. Methods： 94 cases of elderly patients with drug-induced liver injury were retrospectively analyzed. The incidence,etiology,clinical manifestation and prognosis index were comprehensively evaluated and the clinical characteristics of drug-induced liver injury in the elderly were summarized. Results： The average age of these patients with liver damage was 70.37±8.46 years old. The top three drugs inducing liver injury of the elderly were antituberculosis drugs（ 42.55%）,Chinese herbal medicine and Chinese patent medicine（ 20.21%）,and cholesterol-lowering drugs（ 10.64%）. The types of drug-induced liver injury were liver cell type of 61 cases（ 64.89%）,cholestasis type of 24 cases（ 25.53%）and mixed type of 9 cases（ 9.58%）. The liver damage degrees were level 0 of no case,level 1 of 11 cases（ 11.70%）,level 2 of 32cases（ 34.04%）,level 3 of 49 cases（ 52.13%）,level 4 of 2 cases（ 2.13%）,and level 5 of no case. There was no significant difference in the male-female ratio of the patients with moderate and severe liver injury. Conclusions： Conclusions： The elderly drug-induced liver injury prevention should be taken seriously enough.