药物性肝损害107例临床分析

目的探讨引起药物性肝病的常见药物、发病规律、诊断及临床特点,以提高对该病的认识,及早作出正确的诊断和治疗。方法对2000-01～2006-12本院的药物性肝损害住院患者采用回顾性研究。结果引起肝损害的药物种类繁多,以抗生素(包括抗结核药物)为最多,占30.84%,其次为中药(18.69%),解热镇痛类药物(7.48%),抗肿瘤药物(5.61%);临床类型为肝细胞型多见,占57.95%,胆汁淤积型占23.36%,混合型占18.69%;主要临床表现有纳差、乏力、黄疸、恶心、呕吐等;多数病人预后较好(89.72%)。结论可引起药物性肝损害的药物种类繁多,其临床表现和实验室检查缺乏特异性;严格把握用药指征,注意监测肝功能是有效的预防措施。

A clinical analysis of 107 patients with drug-induced liver disease

Objective To improve the early diagnosis and treatment of drug-induced liver disease by summarizing its clinical features. Methods One hundred and seven cases of drug-induced liver disease admitted to our hospital from Jan 2000 to Dec 2006 were reviewed retrospectively. Results A variety of drugs could cause liver disease. The offending agents could be classified as follows:antimicrobial agents(including antituberculotic drugs) (30.84%), traditional Chinese herb medicine (18.69%),antipyretic, analgesic, and anti-inflammatory(7.48%),anticancer drugs (5.61%).And of 107 cases, 57.95% was classified as hepatocellular type, 23.36% as cholestatic type, and 18.69% as mixed type. The main clinical manifestations were fatigue, nausea, vomiting and jaundice. Most of 107 cases (89.72%) had better prognosis. Conclusions A variety of drugs can induce liver disease, and the clinical fatures are of no specificity. To control the drug indication strictly and monitor liver function should be effective measures for prevention.