33例何首乌及其相关制剂致药物性肝损伤临床分析

Clinical Analysis of 33 cases of Drug Induced Liver Injury caused by Polygonum Multiflorum Thunb and Its Preparations

目的:分析何首乌及其相关制剂所致药物性肝损伤(DILI)的临床特征,探讨影响其预后的相关因素。方法:收集2016年1月至2016年12月于本院住院诊断为DILI患者中存在何首乌及相关制剂应用史的患者33例,采用多元相关分析探讨影响转归的各个因素。结果:33例患者中,女性多于男性,平均年龄(45.33±17.55)岁。肝损伤临床分型:肝细胞型损伤31例,混合型损伤1例,无法分型1例。转归情况:治愈9例、好转19例、无效或死亡5例。通过分析,得出转归情况与性别、年龄、是否有过敏史、是否为何首乌单品、自身免疫抗体阳性、是否有基础病均无显著性相关(P>0.05),而患者初发时Alb、GGT、TBil和INR水平与预后呈显著性相关(P<0.05)。结论:何首乌及其相关制剂所致药物性肝损伤多为肝细胞损伤型,初始发病时肝功能及凝血功能状态与其转归存在相关性。

Objective： To analyze the clinical features of drug induced liver injury induced by Polygonum multiflorum Thunb and its prep- arations, and to explore the prognostic factors. Methods： a retrospective analysis was conducted on 33 cases of liver injury caused by Polygo- num muhiflorum Thunb. From January 2016 to December 2016. Results： Among the 33 patients, females were more than males, with an av- erage age of （45.33 ＋ 17.55） years. Classification of drug-induced hepatic injury was made： hepatocellular injury 31 cases, mixed type in- jury 1 case, unable to parting 1 case. Outcome ： 9 cases cured, 1 9 cases improved , 5 cases invalid or death. Through the analysis of variance and correlation analysis of clinical data： The outcome and gender, age, history of allergies, whether the medicine is just Polygonum multiflorum Thunb, autoimmune antibodies, whether the underlying disease were not significantly related （P 〉 0.05 ）, and patients with ALB, GGT, TBiL and INR were significantly correlated （P 〈 0. 05 ）. Conclusion： The drug induced liver injury induced by Polygonum multiflorum Thunb and its related preparations is mostly hepatocyte injury, the correlation between liver function and coagulation function and its outcome during initial onset.