药物性肝炎的临床特征分析

Clinical Analysis of the Characteristics of Drug Hepatitis

目的:分析中药与西药所诱导的药物性肝炎的临床特征。方法:回顾性分析2014年9月至2018年12月甘肃省人民医院收治的151例药物性肝炎患者的临床资料,并进行临床特征分析。结果:大部分药物性肝炎的严重程度为中度及以上,其中由中药诱发的中度/重度/肝衰三级占比分别为:26.32%(15/57)、42.11%(24/57)及12.28%(7/57),西药诱发占比分别为28.77%(21/73)、27.40%(20/73)及0.00%(0/73),中西药占比分别为28.57%(6/21)、33.33%(7/21)及4.76%(1/21)。西药诱发的药物性肝炎中肝细胞型占79.45%(58/73),胆汁淤积型占6.85%(5/73),混合型占13.70%(10/73)。中药诱发的药物性肝炎肝细胞型及胆汁淤积型均占38.60%(22/57),混合型占22.80%(13/57)。中西药诱发的药物性肝炎肝细胞型占61.91%(13/21),胆汁淤积型占28.57%(6/21),混合型占9.52%(2/21)。结论:西药与中药在导致药物性肝炎方面存在一定差异,中药引起的药物性肝炎比西药引起的更严重。

Objective:To analyze clinical characteristics of drug hepatitis induced by TCM and Western medicine.Methods:Clinical data of 151 cases of drug hepatitis admitted into Gansu Provincial Hospital from September,2014 to December,2018 were retrospectively analyzed,as well as its clinical characteristics.Results:The proportions of TCM inducing drug hepatitis in grade three to five(moderate,severe and liver failure)were 26.32%(15/57),42.11%(24/57)and 12.28%(7/57)respectively,the proportions of western medicine were 28.77%(21/73),27.40%(20/73)and 0.00%(0/73)respectively,the proportions of TCM and western medicine were 28.57%(6/21),33.33%(7/21)and 4.76%(1/21)respectively.79.45%(58/73)of drug hepatitis induced by Western medicine were of hepatocyte type,6.89%(51/73)of cholestasis type and 13.7%(10/73)of mixed type.38.60%(22/57)of drug hepatitis induced by TCM of hepatocyte type and cholestasis type and 22.80%(13/57)of mixed type.61.91%(13/21)of drug hepatitis induced by TCM and western medicine were of hepatocyte type,28.57%(6/21)of cholestasis type and 9.52%(2/21)of mixed type.Conclusion:There are some differences between Western medicine and TCM in the aspects of inducing drug hepatitis,the hepatitis induced by TCM is more serious than that induced by Western medicine.