抗菌药物相关性肝损伤的危险因素分析

Risk factors of drug-induced liver injury due to antibiotics

目的分析抗菌药物相关性肝损伤的危险因素。方法选取2012年1月至2019年8月在宁波市第一医院诊断并接受治疗的抗菌药物相关性肝损伤患者131例为观察组,分析其导致肝损伤的药物种类分布;另选取同期在本院接受抗菌药物治疗但未发生肝损伤的患者131例为对照组,比较两组患者临床特征。采用多因素logistic回归分析抗菌药物相关性肝损伤的危险因素。结果导致抗菌药物相关性肝损伤的药物种类主要有三唑类(21.4%)、头孢菌素类(19.8%)、喹诺酮类(16.8%)、碳青霉烯类(16.0%)和青霉素类(12.2%)。年龄大(OR=2.678)、合并用药(OR=2.362)是影响抗菌药物相关性肝损伤的独立危险因素(均P<0.05)。结论应用抗菌药物前要认真评估患者身体状况,用药后密切监测其肝功能指标,尤其是年龄大、合并用药的患者。

Objective To analyze the risk factors of drug-induced liver injury due to antibiotics.Methods One hundred and thirty-one patients diagnosed with antibiotics-related liver injury treated in our hospital from January 2012 to August 2019 were enrolled(liver injury group);131 patients without antibiotics-related liver injury were selected as the control group.The types and distribution of drug-induced liver injury were analyzed.In addition,the clinical data of the two groups were compared,and the risk factors of drug-induced liver injury due to antibiotics were analyzed by multi-factor logistic regression analysis.Results The main antibiotics leading to drug-induced liver injury were triazoles(21.4%),cephalosporins(19.8%),quinolones(16.8%),carbapenems(16.0%)and penicillins(12.2%).Older age(OR=2.678)and combined medication(OR=2.362)were independent risk factors for antibiotics-related liver injury(all P<0.05).Conclusion The study suggests that the physical condition of patients should be carefully evaluated before antibiotics use and the liver function should be closely monitored during medication,especially for patients with high-risk factors.