共查询到20条相似文献,搜索用时 171 毫秒
1.
2.
芫菁科昆虫斑蝥(Mylabris)是我国经典大毒抗肿瘤中药之一,斑蝥素(Cantharidin,CTD)是其主要活性成分。因其具有独特的升白提高免疫的优势,CTD类上市中药大品种已成为目前临床联合化疗的主流用药。然而,民间常因为误食、多食频发斑蝥中毒事件,临床应用也常出现副作用,尤其是肝、肾毒性。其靶器官损伤机制的研究尚不十分清楚,极大地制约了其临床应用,因此亟需厘清斑蝥病理损伤及毒理机制。本文对近年来斑蝥致肝、肾毒性研究进行综述,探析其共性毒性规律、毒理机制及减毒保护策略,以期为斑蝥的减毒策略及新药研发提供参考。 相似文献
3.
4.
5.
《抗感染药学》2017,(7):1273-1279
中药半夏具有肝、肾、肠毒性,引起功能异常和组织病理损伤。半夏还具有强烈的刺激毒性,引起接触部位的组织(嘴唇、口腔、声带、胃肠、眼等黏膜)发生炎症反应。半夏也具有致突变和生殖毒性,引起母体阴道出血、胚胎早期死亡,并流产,产生"抗早孕"作用。这些毒性均以生半夏为最大,生半夏经炮制或加热(如水煎)毒性减弱,甚至消失。半夏生物碱可能是致肝毒性的主要成分。半夏草酸钙针晶及其携带的半夏凝集素是半夏刺激毒性的主要成分,其中针晶引起机械性刺激,而半夏凝集素引起化学性刺激毒性。半夏凝集素也是"抗早孕"的活性成分。综述中药半夏致急慢性毒性、剌激毒性、突变毒性和"抗早孕"生殖毒性药理作用的研究文献资料,并对其研究进展做了分析,为临床合理使用中药半夏提供参考。 相似文献
6.
近年来,中药及天然药物肝损伤的报道不断增多,中药致肝损伤的风险日益引起国内外的关注。本文对中药肝损伤流行特点、风险因素和临床特点等方面进行了讨论,对目前在中药肝损伤研究及认识方面的误区进行了剖析,并结合中药及临床使用特点,提出了中药肝毒性预测、基础及临床安全性评价方面建议关注和研究的内容,以期为中药肝毒性的科学评价提供参考。 相似文献
7.
川乌为乌头的母根,化学成分复杂,具有多种功效,但毒性较强,心脏毒性是其主要毒性之一。乌头碱作为主要致毒成分,通过强烈兴奋迷走神经和引起心肌细胞内钙离子浓度的急剧变化,进一步引起细胞膜通透性增加、细胞器变性、DNA损伤、心肌细胞凋亡等,最终引起心脏损伤。此外,乌头碱也可损伤血管内皮细胞。临床上可通过采用及时并彻底清除毒物,使用抗心律失常药物,血液净化等措施来治疗川乌中毒。了解川乌心血管系统毒性,毒理机制及应对策略对于川乌的临床应用有较大的意义。 相似文献
8.
目的梳理近10年来基因组学、蛋白质组学、代谢组学等系统生物学技术在中药肝毒性标志物筛选、肝毒机制研究、毒性预测与毒性蛋白质、基因组数据库建立等方面研究进展与应用前景。方法对近10年来国内外发表的相关文献进行分析、整理和归纳。结果与传统毒理学研究方法相比,系统生物学技术可更快、更准确地发现毒性物质,用于潜在的生物标记物寻找和毒靶研究,也可作为机制研究的补充和验证;但受技术限制在应用中尚存在缺乏规范的毒性评价体系、缺乏足够的基础数据等问题。结论系统生物学技术提升了中药肝毒机制的认知水平,在中药肝毒性评价、机制研究、临床诊断领域提供了一个适宜技术,尤其为肝毒性生物标记物发掘、肝毒性预警奠定了技术可行性。 相似文献
9.
10.
11.
目的了解抗真菌药肝毒性的研究情况及其临床特征,为安全使用抗真菌药提供参考。方法以“antifungal drugs”和“hepatotoxicity”“、抗真菌药”和“肝毒性”为检索词,检索PubMed、Embase、Web of Science、中国知网中国期刊全文数据库和中国生物医学文献数据库收录的抗真菌药肝毒性文献,用Excel表对最终纳入的文献建立评价数据库,录入文献的发表年代、发文量排序前5位的国家及研究机构、文献类型、载文量前5位的期刊、被引频次前10位的文献等。分析有关文献的研究内容和热点,总结抗真菌药肝毒性的临床表现、发生机制及预防措施。结果共纳入文献221篇,其中英文文献193篇,中文文献28篇;论著116篇,综述49篇,病例报告56篇。首次发表抗真菌药肝毒性文献的时间是1976年,载文量最高的期刊是Mycoses,单篇文章的最高被引频次为531次。抗真菌药致肝损伤的临床表现为乏力、右上腹疼痛、腹泻、黄疸、胆汁淤积和发热等,严重者可致肝衰竭。实验室检查可见血清转氨酶、胆红素、碱性磷酸酶升高。唑类抗真菌药致肝损伤发生率较高,两性霉素B致肝损伤发生率较低。肝功能不全者应慎用抗真菌药。长期应用抗真菌药者应注意定期监测肝功能,出现肝损伤后立即停药并采取对症与保肝治疗,部分患者的肝功能可恢复至用药前水平。抗真菌药肝毒性的机制尚不完全清楚,可能与细胞质膜结构完整性受损或抑制细胞色素P4502D6酶代谢有关。结论国内对抗真菌药肝毒性的研究逊于国外;部分抗真菌药所致肝毒性呈可逆性。 相似文献
12.
中药的广泛使用,提高了肝脏毒性发生风险。斑马鱼模型在肝脏毒性研究中显现出较大潜力的同时,也面临评价标准难以统一的问题。在使用斑马鱼进行药物肝损伤检测和评价之前应先明确其在不同生长阶段的肝功能状态,利用斑马鱼胚胎和幼鱼的通体透明的特点,以胚胎的孵化率、死亡率、畸形率作出初步的发育毒性判断,以幼鱼肝脏灰度值,肝脏面积大小,卵黄囊吸收程度作为药物是否具有肝脏毒性的判断标准,利用成鱼肝脏容易分离的特点研究肝脏毒性的作用机制。检测时可根据这些指标判断斑马鱼肝脏发育阶段,为其是否发生药物肝损伤提供依据,从而进一步提高临床用药安全性。综述了不同发育时期斑马鱼评估中药肝毒性的研究方法及研究进展,以期为后续中药的肝脏毒性评价提供参考。 相似文献
13.
Depression is a chronic, severe and increasingly prevalent illness associated with substantial morbidity, mortality and healthcare costs. Antidepressant drugs, the cornerstone of depression treatment, are not devoid of adverse effects, including hepatotoxicity. To review the risk of liver toxicity related to major antidepressants, the authors have followed structural criteria focusing on the underlying mechanism presumably involved and the role of particular chemical structures. The clinicopathological expression goes from transient increases in liver enzymes to fulminant liver failure. Classical antidepressants such as monoamine oxidase inhibitors (MAOIs) or tricyclic antidepressants (TCAs) seem to have the highest potential to induce liver damage compared with the newer drugs such as selective serotonin re-uptake inhibitors (SSRIs). The potential for severe hepatotoxicity associated with nefazodone is stressed. Guidelines for therapy and prevention of antidepressant-induced hepatotoxicity are also discussed. 相似文献
14.
15.
中成药致肝炎的病例分析 总被引:10,自引:1,他引:9
郭丽珠 《药物不良反应杂志》2004,6(4):231-235
目的:探讨中成药所致肝损害的相关药物、发病机制及防治。方法:对本院1991-2003年收治的103例中成药所致肝炎进行统计,从发病趋势、相关药物、临床表现、治疗及预后几个方面进行分析。结果:中成药所致药物性肝炎,以治疗骨关节病药物占首位,其次为皮肤病用药。临床表现以肝细胞损害为主,也有表现为胆汁淤积型肝炎者。经西药或中西医结合治疗后,绝大部分痊愈和好转。结论:中成药所致肝损害集中发生于治疗骨关节病与皮肤病两类药物,表明该两类药物可能含有某些肝毒性成分或者与配伍等因素相关,确切机制有待于进一步研究。加强临床监测和信息交流有助于及时发现及预防肝损害的发生。 相似文献
16.
17.
Ziheng Wei Qingqing Qian Xu Dong Na Li Guangchun Sun 《Toxicology mechanisms and methods》2017,27(9):687-696
Veratrum nigrum L. (VN) is a poisonous traditional Chinese medicine herb present since thousands of years in China. Clinical studies have shown that VN has the ability to cause hepatotoxicity, which severely limits its clinical use. The mechanism of its hepatotoxicity has not been fully elucidated. The purpose of this study was to develop and characterize a model of acute and chronic hepatotoxicity induced by Veratrum nigrum L. extract (VNE) to understand the mechanism of liver tissue metabolomics approach using on ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOFMS). Mice were administered with VNE in the acute and chronic phases. Histopathologic inspections and biochemistry analysis disclosed severe liver damage after exposure to VNE. A partial least-squares discriminant analysis (PLS-DA) of the metabolomic profiles of rat liver tissues highlighted a number of metabolic disturbances induced by VNE, focusing on purine and pyrimidine metabolism, tryptophan metabolism, phospholipid metabolism, sphingolipid metabolism and fatty acid metabolism. These findings could well explain VNE-induced acute and chronic hepatotoxicity and reveal several potential biomarkers associated with this toxicity. This indicates that UHPLC-Q-TOFMS-based metabolomics approach demonstrated its feasibility and allowed a better understanding of VNE-induced liver toxicity dynamically. 相似文献
18.
目的分析总结近年来本院药物性肝病(DILD)的情况,提高本病的诊断治疗水平。方法回顾调查本院2004年1月-2008年12月各种药物致药物性肝病147例,分析统计每年药物性肝病发病例数的变迁及临床情况。结果DILD发病率呈上升趋势,占同期急性肝炎的15.36%。引起此病的药物种类多,中药制剂、抗结核药、化疗药、抗菌药物、抗甲亢药是主要的损肝药物。其中中药制剂占34.01%,抗结核药占27.89%,抗肿瘤化疗药占10.20%,抗菌药物占8.84%,抗甲亢药占6.80%;用药1-3月出现肝损害占97.28%,无临床症状者占17.01%,有症状者占82.99%,主要表现为乏力、恶心、呕吐、尿黄、黄疸及肝大等。肝功能损伤表现为ALT、AST、TB、GGT及ALP明显升高。肝细胞损伤型92例,胆汁淤积型22例,混合型33例。经综合治疗后,95.92%治愈或好转,2.72%无变化或加重,1.36%死亡。肝细胞损伤型DILD患者治疗后肝功能较胆汁淤积型DILD患者恢复快。结论DILD发病率上升,涉及药物种类多,临床表现与病毒性肝炎相似,无特异性;药物性肝病的早期诊断与重视程度和认识有关,加强规范合理用药及用药监测可以预防本病。 相似文献
19.
重视中药的肝损伤问题 总被引:15,自引:0,他引:15
根据目前为止的相关报道,中药所致的肝损伤占临床药物性肝损伤总病例的4.8%~32.6%。究其原因,除了没有遵照中医药辨证施治的基本要求,乱用、误用,成药制剂的制备工艺以及培植药材中农药的残留及品种混淆等外,中药本身的不良反应不可忽视。本文就常见致肝损伤的中药及其成分与致肝损害机制,中草药肝损害的临床特点及病理改变,中药致肝损伤的影响因素以及加强预防措施等方面作一概述。希望重视中草药的肝损伤问题,提高中医药服务人民健康的水平。 相似文献
20.
Review article: drug hepatotoxicity 总被引:2,自引:0,他引:2
Background Drug toxicity is the leading cause of acute liver failure in the United States. Further understanding of hepatotoxicity is becoming increasingly important as more drugs come to market. Aims (i) To provide an update on recent advances in our understanding of hepatotoxicity of select commonly used drug classes. (ii) To assess the safety of these medications in patients with pre‐existing liver disease and in the post‐liver transplant setting. (iii) To review relevant advances in toxicogenomics which contribute to the current understanding of hepatotoxic drugs. Methods A Medline search was performed to identify relevant literature using search terms including ‘drug toxicity, hepatotoxicity, statins, thiazolidinediones, antibiotics, antiretroviral drugs and toxicogenomics’. Results Amoxicillin‐clavulanic acid is one of the most frequently implicated causes of drug‐induced liver injury worldwide. Statins rarely cause clinically significant liver injury, even in patients with underlying liver disease. Newer thiazolidinediones are not associated with the degree of liver toxicity observed with troglitazone. Careful monitoring for liver toxicity is warranted in patients who are taking antiretrovirals, especially patients who are co‐infected with hepatitis B and C. Genetic polymorphisms among enzymes involved in drug metabolism and HLA types may account for some of the differences in individual susceptibility to drug hepatotoxicity. Conclusions Drug‐induced hepatotoxicity will remain a problem that carries both clinical and regulatory significance as long as new drugs continue to enter the market. Future results from ongoing multicentre collaborative efforts may help contribute to our current understanding of hepatotoxicity associated with drugs. 相似文献