抗精神病药物致肝功能损伤的回顾性分析

Retrospective analysis of liver function damage caused by antipsychotics

目的调查分析抗精神病药物所致肝功能损伤情况。方法回顾性分析2016年1月至2018年12月于江铜集团东铜医院住院的1205例精神病患者的临床资料,分析抗精神病药物治疗后肝功能异常的发生率、发生时间、致肝功能损伤的药物种类、患者预后。结果抗精神病药物致肝损伤发生率为28.23%(340/1205),肝损伤出现时间为用药后5 d^3个月。致肝损伤的药物有氯丙嗪、氯氮平、奥氮平、氟哌啶醇、奋乃静、舒必利、利培酮、阿立哌唑,其中氯丙嗪占24.25%(83/340),氯氮平占15.94%(54/340),奋乃静占12.88%(44/340),奥氮平占12.12%(41/340)。经对症治疗,312例(91.76%)患者肝功能指标在1~3个月内恢复至正常范围。结论精神病患者抗精神病药物致肝功能异常的发生率较高,多由经典抗精神病药物造成。经对症治疗后,一般预后较好。

Objective To investigate and analyze the liver function damage caused by antipsychotic drugs.Methods The clinical data of 1205 psychiatric patients hospitalized in Jiangxi Copper Group Dongtong Hospital from January 2016 to December 2018 were retrospectively analyzed.The incidence of liver dysfunction after antipsychotic treatment,the time of occurrence,the type of drug,and the prognosis of patients were analyzed.Results The incidence of liver function damage caused by antipsychotics was 28.23%(340/1205),and the damage happened in 5 days to 3 months after administration.The drugs causing liver damage included chlorpromazine,clozapine,olanzapine,haloperidol,perphenazine,sulpiride,risperidone,and aripiprazole.Chlorpromazine accounted for 24.25%(83/340),clozapine accounted for 15.94%(54/340),perphenazine accounted for 12.88%(44/340),and olanzapine accounted for 12.12%(41/340).After symptomatic treatment,liver function of 312(91.76%)patients returned to normal range within 1-3 months.Conclusion The incidence of liver dysfunction caused by antipsychotic drugs is higher.Liver dysfunction is mostly caused by classic antipsychotic drugs.After symptomatic treatment,the general prognosis is good.