急性药物性肝病72例临床分析

目的探讨急性药物性肝病的常见诱发药物、临床表现、分型及预后,以提高对该病的诊断水平。方法对符合诊断标准的72例急性药物性肝病的临床资料进行回顾性分析。结果诱发急性药物性肝病的药物中,抗结核药18例(25%),中草药16例(22·2%),抗生素10例(13·9%),抗肿瘤化疗药物4例(5·6%),抗甲亢药4例(5·6%),其他20例(27·8%)。临床表现为急性肝细胞型47例(65·2%),急性胆汁淤积型16例(22·2%),混合型9例(12·5%)。其中治愈52例(72·2%),好转13例(18·1%),无变化5例(6·9%),恶化2例(2·8%)。结论急性药物性肝病常见的诱发药的前五位为抗结核药、中草药、抗生素、化疗药和抗甲亢药等,应该引起临床医生的足够重视。

Analysis on 72 Cases of Acute Drug Inducing Liver Diseases

Objective To discuss the inducing drugs of acute drug inducing liver diseases (ADLD),and its manifestations,grouping and prognosis and how to enhance the capability of diagnosis to ADLD.Methods Make a retrospective-study to 72 cases of ADLD,which were chose according to diagnosing standards.Results The components of the drugs inducing ADLD are as following:anti-tuberculosis drugs account for 25%(18 cases),traditional and herbal drugs-22.2%(16 cases),antibiotics-13.9%(10 cases),synthetic drugs-5.6%(4 cases),anti-hyperthyroidism drugs-5.6%(4 cases),others-27.8%(20 cases).As to manifestations,acute hepatocallular lesion occupied 65.2%(47 cases),acute cholestasis-22.2%(16 cases),mixed type-12.5%(9 cases).When it comes to cruative effect,curing ranked 72.2%(52 cases),improvement-18.1%(13 cases),unchanged-6.9%(5 cases),depravation-2.8%(2 cases).Conclusion Anti-tuberculosis drugs,traditional and herbal drugs,antibiotics,synthetic drugs and anti-hyperthyroidism drugs rank the first five in the drugs inducing ADLD.The rate of missed diagnosis is still existed in clinical practice because of the lack of unifrom diagnostic standard.