重度及重型药物性肝炎患者临床特征分析

目的探讨重度及重型药物性肝炎的病因、临床特点及治疗效果，为其预防及治疗提供依据。方法 回顾性分析我院2002—2010年收治的198例药物性肝炎患者的临床资料，通过对患者性别、年龄、基础疾病、药物种类及临床治疗治愈率、好转率、病死率、并发症发生率等进行分析，总结重度及重型药物性肝炎的发病规律及特点。结果男性药物性肝炎患者中，重度（29．9％）和重型比例（20．7％）显著高于女性（X^2=4．527，P〈0．05；X^2=5．481，P〈0．05）；合并基础疾病的药物性肝炎患者中，重度（27．5％）及重型比例（18．3％）显著高于无基础疾病患者（X^2=3．951，P〈0．05；X^2=4．409，P〈0．05）；合并肝病患者中，重度（31．9％）和重型比例（21．7％）显著高于无肝病患者（X^2=5．056，P〈0．05；X^2=5．681，P〈0．05）；有肝病的重型患者病死率显著高于无肝病者（X^2=3．977，P〈0．05）；不同药物种类中，重型肝炎的病死率无显著区别（X^2=0．075，P〉0．05）。结论有肝病基础的药物性肝炎患者重度及重型发生比例较高，有肝病基础者重型病死率高于无肝病者。

Clinical features of patients with severe and gravis drug - induced hepatitis

Objective To disuss the causes, clinical features and therapeutic efficacy of severe and gravis drug - induced hepatitis in order to provide information for its prevention and treatment. Methods A retrospective analysis of clinical data was made among 198 cases of drug - induced hepatitis in our hospital from 2002 to 2010. The development rule and characteristics of severe and gravis drug- induced hepatitis were summarized by analysis of patients＇ gender, age, basic diseases, category of drugs, and clinical parameters such as cure rate, improvement rate, case fatality, incidence of complication, etc. Results Among the male patients, the ratio Of severe type （ 29.9% ） to gravis type （20.7 % ） was significantly higher than that in female patients （X^2 = 4.527, P 〈 0.05 ;X^2 = 5.481, P 〈 0.05 ）. The ratio of severe type （27.5%）to gravis type （18.3%）in patients with drug - induced hepatitis combined with basic diseases was significantly higher than that in patients without any basic disease （X^2 = 3.951, P 〈 0.05 ;X^2 = 4. 409, P 〈 0.05）. The ratio of severe type （31.9% ）to gravis type （21.7%）in patients with complication of liver diseases was significantly higher than that in ones without other liver diseases （X^2 = 5. 056,P 〈 0.05 ;X^2 = 5.681, P 〈 0.05 ）. The morbidity of patients with gravis drug - induced hepatitis combined with hepatic diseases was significantly higher than that of ones without hepatic disease（X^2 = 3. 977 ,P 〈 0.05 ）. According to different categories of drugs, there was no significant difference in the morbidity among patients with gravis drug - induced hepatitis （X^2 = 0.075,P 〉 0.05 ）. Conclusion The incidence of severe and gravis drug - induced hepatitis is higher among patients with the complication of liver diseases, and the case fatality of those patients with gravis type is higher than that of ones without the complication of liver disease.