86例老年人药物性肝损害的病因和临床特点

目的探讨老年人药物性肝损害的病因和临床特点，以提高对该病的认识。方法对2004—2010年间我所住院的86例药物性肝损害的资料进行回顾性分析，并按Marin药物性肝损害评分系统进行评价。结果引起药物性肝损害的药物类型居前四位的依次为抗微生物药物19例、抗肿瘤药17例、中草药16例与心血管用药14例，分别占22％、19．8％、18．6％与16．3％，其后为神经科用药和解热止痛药分别为4％，再次为降糖药、抗甲亢药、免疫抑制剂各占2．3％，雄性激素1．2％。8例不详占5．8％。临床分型：肝细胞型49例占57％，胆汁淤积型25例29％，混合型12例占14％。结论抗微生物药、抗肿瘤药、中草药和心血管用药是引起老年人药性肝损害的较常见的药物，使用此类药物时宜小心谨慎，密切监测肝功能的变化。

The etiology and clinical features of 86 cases of drug-induced liver injury in old people

Objective To enhance the understanding of drug-induced liver injury by investigating the causes and clinical features of drug-induced liver injury cases in old people.Methods Eightsix drug-induced liver injury cases in old people admitted to our hospital from 2004-2010 were retrospectively analyzed and evaluated by using Maria's diagnostic scale.Results The four predominant etiological drugs were antibiotics ( 19 cases,22％ ),antitumor drugs ( 17 cases,19.8％ ),traditional Chinese herbs ( 16 cases,18.6％ ) and cardiovascular drugs ( 14 cases,16.3％ ),followed by neurologists medicines ( 4％ ) and antipyretic analgesics ( 4％ ).Other drugs included glucose-lowing drugs,hyperthyroidism drugs and immunosuppressive agents,each of them accounted for 2.3％ of the all cases.1.2％cases attributed to male hormone drugs and the causative drugs could not be clarified in 8 cases ( 5.8％ ).For clinical classification,49 cases ( 57％ ) were hepatocellular type,25 cases ( 29％ ) were cholestasis type,and 12 cases ( 14％ ) were mixed type.Conclusions Antibiotics,antitumor drugs,traditional Chinese herbs and cardiovascular drugs are the common drugs cause drug-induced liver injury among old people,doctors should be discreet and closely monitor the liver function when using these drugs.