药物性肝损伤139例回顾性分析

Retrospective analysis of 139 cases of drug-induced liver injury

目的探讨某医院药物性肝损伤(DILI)患者的临床特点、病因构成及应对策略。方法采用Roussel Uelaf因果关系(RUCAM)量表选择某医院DILI患者139例,收集其临床资料,分析其临床特点和用药情况。结果RUCAM量表共筛选出139例DILI,患者45~59年龄段占比最高(38.85%),61.15%患者有临床表现,其中以纳差最多见。药物性肝损伤以肝细胞损伤型最多(87.05%)。肝细胞损伤型治疗有效率高于胆汁淤积型和混合型。共涉及88种可疑药物,排名前3位依次为抗结核药物、抗肿瘤药物和中药。51.08%患者联用2种以上可疑药物。结论DILI隐蔽性强,可由多种药物引发,应提高对DILI的认识和预防,从而降低DILI的发生。

Aim To explore clinical characteristics,cause of disease constitution and coping strategies of patients with drug-induced liver injury(DILI)in a hospital.Methods The Roussel Uelaf causality relationship(RUCAM)scale was used to select 139 patients with DILI in a hospital.The clinical data of patients were collected,and the clinical characteristics and drug use were analyzed.Results A total of 139 patients of DILI were screened by the RUCAM scale.45~59 age group accounted for the highest proportion(38.85%)and 61.15%of patients had clinical manifestations,among which anorexia(35.97%)was the most common.The main clinical type of the drug-induced liver injury was the hepatocyte injury type(87.05%).The treatment efficiency of hepatocyte type was higher than the cholestasis type and the mixed type.A total of 88 kinds of suspicious drugs were involved in this study,in which the top three were anti-tuberculosis drugs,anti-tumor drugs and traditional Chinese medicine.51.08%of patients were combined with two or more suspicious drugs.Conclusions DILI is highly concealed and could be triggered by a variety of drugs.The awareness and prevention of DILI should be improved to reduce the occurrence of DILI.