144例药物性肝损伤的临床特点及影响因素分析

Clinical investigation of 144 patients with drug-induced liver injury and its influencing factors analysis

目的分析药物性肝损伤(DILI)的临床特点及其影响因素,为合理用药提供支持。方法根据我国常用药物性肝损伤诊断标准,对2013年10月至2015年10月在湘雅三医院住院的144例DILI患者的临床资料进行回顾性分析。结果 144例DILI患者中,男性占53.47%(77/144例),女性46.53%(67/144例),平均年龄(44.32±16.02)岁,45岁以上50.70%(73/144例)。致肝损伤的药物包括中药23.61%(34/144例),免疫抑制剂20.83%(30/144例),抗结核药15.97%(23/144例),抗肿瘤药物7.64%(11/144例)等。本研究144例患者治愈18.75%(27/144例),好转22.92%(33/144例),未愈及其他为58.33%(84/144例),平均住院16 d。年龄、性别、发病时间对DILI的预后没有影响(P>0.05),起病时肝功能指标对DILI预后有影响(P<0.05)。结论本次研究中DILI在中老年人中的发病率较高,多种药物会引起DILI,以中药、抗结核药物及免疫抑制剂居多。

Objective In order to provide support for the rational use of drugs, we summarize the clinical characteristics of patients with drug-induced liver injury（ DILI） and statistics of the allergic drugs.Methods According to the common drug-induced liver injury diagnostic criteria of our country,the clinical data of 144 hospitalized cases in the third Xiangya hospital with DILI were analyzed retrospectively,then,potential pathogenic drugs were summarized. Results A total of 144 patients with DILI were enrolled in this study： male account for 53. 47%（ 77/144 cases）,female account for 46. 53%（ 67/144 cases）. The average age was（ 44. 32 ± 16. 02） years old,and 50. 70%（ 73/144 cases） of the patients were over 40 years old. Liver injury was caused by several kinds of drugs,23. 61%（ 34/144 cases） were traditional Chinese medicine,20. 83%（ 30/144 cases） were immunosuppressive agents,15. 97%（ 23/144 cases） were anti-tuberculosis drugs,7. 64%（ 11/144 cases） were antineoplastic drugs. 18. 75%（ 27/144 cases） patients were cured,22. 92%（ 33/144 cases） patients got better while others account for58. 33%（ 84/144 cases）,and the average hospitalization days of patients with DILI were 16 days. Age,gender and duration of the disease had no significant effect on prognosis（ P〈0. 05）,while there were significant differences between liver function indexes and prognosis（ P〈0. 05）.Conclusion In this study,the incidence of DILI was higher in elderly people. A variety of drugs were able to cause DILI,including traditional Chinese medicine,immunosuppressive agents and anti-tuberculosis drugs.