药物性肝损伤78例临床特点分析

目的探讨药物性肝损伤（DILI）病例的病因、临床特点及预后,为临床诊治提供理论参考。方法回顾性分析2009年1月～2010年12月首都医科大学附属北京友谊医院肝病科住院治疗的78例DILI患者的年龄、性别、中毒药物种类、名称、起病时间、肝功能、凝血功能、是否肝活检、治疗情况及预后。结果 78例患者中女性53例（67.95%）,男性25例（32.05%）;中老年组病例占多数,以50～59岁年龄组最高（32.05%）,大于50岁以上的病例数占64.10%;西药、中药及化学品所致DILI比例分别为50.00%、47.44%及2.56%,中药、西药两类药物所致DILI在临床特点方面差异无统计学意义,其中急性DILI共63例（80.77%）,中重度损伤共62例（79.49%）,肝细胞型56例（71.79%）,治愈/好转75例（96.15%）;34例患者（43.59%）经肝穿刺活组织病理检查确诊。结论临床DILI病例以中老年多见,女性较男性常见,中西药所致肝损伤比例相近,以急性损伤、中重度病例为主,及时治疗多数预后良好。

Analysis of the clinical characteristics of 78 cases of drug - induced liver injury

Objective To investigate the etiology,clinical characteristics and prognosis of hospitalized drug-induced liver injury（DILI） cases,in order to provide theoretical references for the clinical diagnosis and treatment of DILI.Methods Summary of 78 patients,history with DILI from liver-disease-division in Beijing Friendship Hospital affiliated to the Capital University of Medical Sciences from January 2009 to December 2010 were restrospectively analysed.The researched factors include the age,sex,toxic-drugs＇ names,damage types,time of onset,liver function,prothrombin time,whether or not liver-biopsied,treatment and prognosis.Results Among 78 patients with DILI,53 are female patients（67.95%）,while male patients are 25（32.05%）.The majority are old-patients,with 50-59 years-age group being the highest（32.05%）.The number of cases with age beyond 50 accounts for 64.10%.The proportion of DILI caused by western-medicine and Chinese-medicine are basically similar（50.0% to 47.44%）.The clinical characteristics did not show statistical difference in DILI caused by two types of drugs.Among them 63 patients were with acute-DILI,accounting for 80.77%;62 patientswith moderate to severe injury,accounting for 79.49%;56 patients with Liver cell-damage,accounting for 71.79%;75 patients with treatment-responses,accounting for 96.15%;34 patients with transjugular living tissue pathology,accounting for 43.59%.Conclusion The old patients are the majority in DILI.Female patients being more prone compared to male patients.The proportion of DILI caused by Chinese medicine or western medicine are basically similar.The cases of acute,moderate to severe-damage are priorities.The prognosis of most cases are good when timely-treated.