141例药物性肝衰竭临床特征及预后分析

目的 探讨药物性肝衰竭的病因、临床特征及预后.方法 回顾性总结我院2002年1月-2011年4月收治的141例药物性肝衰竭(drug-induced liver failure,DILF)的临床资料,分析其药物种类、并发症、预后等相关指标.结果 女性发生DILF比例高于男性,发病年龄以青中年为主.急性DILF41例(2...

Clinical features and prognosis of 141 patients with drug-induced liver failure

Objective To investigate the etiology, clinical features and prognosis of patient with drug-induced liver failure （DILF）. Methods Clinical data of 141 DILF patients admitted to our hospital from Jan. 2002 to Apr. 2011 were reviewed and drug use, complications and prognosis of those patients were analyzed. Results The female patients with DILF were more than the males. DILF mainly occurred in young and middle-aged persons. Among 141 patients, 41 （29.1%） suffered from acute DILF, 84 （59.6%） subacute DILF and 16 （11.3%） chronic DILF, respectively. The three top underlying diseases were skin disease, tuberculosis and upper respiratory infection. The 4 kinds of drugs causing DILF were herbal medicines, antibiotics, antipyretic and analgesic drugs and anti-tuberculosis drugs. Twenty-one patients （14.9%） were cured, 33 （23.4%） improved, 72 （51.1%） were ineffective and 15 （10.6%） died. The 3 most commonly seen complications were pleural effusion and ascites, electrolyte disorder and hepatic encephalopathy. The complications influencing the prognosis were hepatic encephalopathy, hyponatremia, cerebral edema, alimentary tract hemorrhage, septic shock and hemorrhagic shock. Conclusions The predominant type of DILF is sub-acute liver failure. DILF Patients have high mortality and poor prognosis. Liver function should be monitored when herbal medicines, antibiotics, antipyretic and analgesic drugs or antituberculosis drugs are used in DILF Patients.