药物性胆汁淤积症研究进展

Research Progress of Drug-Induced Cholestasis

目的为药物性胆汁淤积症(DIC)的临床合理用药、鉴别诊断及治疗提供依据。方法总结DIC的分类、与肝脏损伤的关系、发生机制、相关致病药物和作用机制,以及其诊治及护理的研究进展。结果DIC分为急性和慢性,与肝脏损伤密切相关;发生机制包括转运蛋白改变、肝细胞变化、胆小管动力学改变等;致病药物包括精神类药物、抗菌药物、抗肿瘤药物、非甾体抗炎药物、抗真菌药物、性激素及类固醇等;临床主要用熊去氧胆酸治疗,一些新的药物也在研发中。结论需更重视针对DIC致病机制药物的研发,并加强预防和监测,确保用药安全。

Objective To provide a basis for clinical rational drug use,differential diagnosis and treatment of drug-induced cholestasis(DIC).Methods The classification of DIC,its relationship with liver injury,its mechanism,DIC-related pathogenic drugs and mechanism,and the research progress of its diagnosis,treatment and nursing were summarized.Results DIC is divided into acute and chronic DIC,which is closely related to liver injury.The mechanism includes the changes in transporters,hepatocytes and bile duct dynamics.Causative drugs include psychotropic drugs,antibiotics,anti-neoplastic drugs,non-steroidal anti-inflammatory drugs,anti-fungal drugs,sex hormones,steroids,etc.Ursodeoxycholic acid is mainly used in clinical treatment,and some new drugs are also being in research and development.Conclusion Clinical practice should pay more attention to the research and development of drugs for the pathogenesis of DIC,and strengthen prevention and monitoring to ensure medication safety.