某院消化内科病房40例药物性肝损伤综合分析

目的 探讨药物性肝损伤病例发生的特点.方法 收集2011年1月-2015年12月某医院消化内科病房的药物性肝损伤病例,每例患者填写药品不良反应报告表,详细记录患者性别、年龄、可疑药品使用情况、药物性肝损伤发生及处理情况,并进行临床分型,将所有数据使用Excel软件进行统计分析.结果 共收集药物性肝损伤病例40例,其中女性18例,男性22例;＞45岁的中老年患者占所有发病人数的70％;中草药和中成药导致的药物性肝损伤共有25例,高达62.5％,其他依次为抗感染药物、免疫系统用药、消化系统用药、抗痛风药、心血管系统用药、内分泌系统用药.33例(82.50％)患者用药开始到肝损伤发生的时间在5～90 d.39例患者从停药开始到肝损伤发生的时间≤15 d,只有1例肝血管损伤型超过30 d.32例患者对症治疗后好转,8例由土三七导致的肝小静脉闭塞症无法逆转,留下后遗症.结论 临床药师应积极推动药物性肝损伤的防治工作,协助医师制定合理的药物治疗方案,避免药物滥用,以减少药物性肝损伤的发生.

Comprehensive analysis of 40 drug-induced liver injury cases in digestive department ward of a hospital

Objective To explore the characteristics of drug-induced liver injury cases. Methods Drug-induced liver injury cases were collected in department of gastroenterology in a hospital of Anhui province from January 2011 to December 2015.The information of each patient,such as gender,age,usage of suspected drugs, occurrence of drug-induced liver injury and treatment of adverse drug reactions,was recorded.Then clinical classification was performed and all the data were statistically analyzed by the Excel software. Results A total of 40 cases of drug-induced liver injury were collected,including 18 female cases and 22 male cases.The elderly patients aged more than 45 years old accounted for 70% of the total cases.25 cases of drug-induced liver injury were caused by Chinese medicines and Chinese herbal medicine,accounting for as high as 62.5%.The other causes were anti-infective drugs,immune system drugs,digestive system drugs,antigout drugs,cardiovascular system drugs,and endocrine system drugs in sequence.The duration from drug use to liver injury of 33 (82.50%) patients were 5 to 90 d.The duration from drug withdrawal to liver injury of 39 patients were less than 15 d.Only 1 liver blood vessel damage type had a duration of more than 30 d.After symptomatic treatment,32 patients improved.Yet 8 cases of hepatic venular occlusive disease caused by gynura segetum were irreversible and had sequela. Conclusions In order to reduce the occurrence of drug-induced liver injury,clinical pharmacists should actively promote the prevention and treatment of drug-induced liver injury and help physicians make rational drug therapy to avoid drug abuse and reduce the occurrence of drug-induced liver injury.