130例肿瘤内科住院患者药物性肝损伤临床分析

Clinical Analysis of 130 Cases of Drug-induced Liver Injury in Cancer Patients

目的分析我院肿瘤内科住院患者发生药物性肝损伤的情况,总结肝损伤的临床表现,评价药物因果关系。方法回顾性追踪2014年1月~2018年12月在我院肿瘤内科住院期间发生药物性肝损伤的患者信息,运用RUCAM评分表进行药物性肝损伤因果关系的评价。结果我院肿瘤内科共有130名患者发生药物性肝损伤,男性72名,女性58名,平均年龄为(64.4±10.71)岁,肝损伤的主要临床表现为乏力、皮肤黏膜黄染、腹部疼痛、纳差等。64例患者为胆汁淤积型,20例为肝细胞损伤型,46例为混合型,化疗药物引起肝损伤出现频次最高的是替吉奥、阿帕替尼、卡培他滨、奥沙利铂、顺铂等。结论化疗药物引起的药物性肝损伤是导致肿瘤内科患者病情变化的重要原因之一,医务人员在医疗监护过程中应加强对药物性肝损伤的重视。

Objective To study the incidence of drug-induced liver injuries among inpatients at the Oncology Department of our hospital,summarize the clinical manifestations of liver damage,and evaluate the causality of drugs.Methods The medical history of drug-induced liver injuries that occurred in our hospital between January 2014 and December 2018 was retrospectively analyzed while the basic information of patients was recorded.The RUCAM score table was used to evaluate the causality of drug-induced liver injuries.Results A total of130 patients treated at the Department of Oncology of our hospital sustained drug-induced liver injuries,including 72 males and 58 females,with an average age of(64.4±10.71)years.The main clinical manifestations of liver injury were fatigue,yellowing of skin and mucous membrane,abdominal pain and anorexia.Sixty-four of these cases were of the cholestasis type,20 cases of the hepatocyte damage type,and 46 cases were of the mixed type.Liver damage associated with chemotherapeutic agents was the most frequent with tegio,apatinib,capecitabine,oxaliplatin and cisplatin.Conclusion Drug-induced liver injury caused by chemotherapeutic drugs is one of the important causes of changes in the conditions of patients in the oncology department of internal medicine.Medical personnel should pay more attention to drug-induced liver injuries in the process of medical care.