急性重症药物性肝损伤患者发病状况的回顾性研究

目的回顾性研究急性重症药物性肝损伤患者的发病状况,以期对临床用药起到指导作用。方法回顾性研究2003年5月-2013年5月广西梧州中医医院收治的急性重症药物性肝损伤的患者82例,对急性重症药物性肝损伤患者的住院诊治情况和可能导致急性重症肝损伤的药物和致死药物进行分析。结果患者的治疗方式包括行人工肝治疗和单纯药物治疗,比例分别为34.15%和65.85%。在患者治疗的过程中死亡31例(37.80%),病情恶化30例(36.59%),病情好转13例(15.85%),治愈8例(9.76%);引起肝损伤的前3类药物分别是中草药、抗结核药物和抗菌药物,致病率分别为28.05%、24.39%和14.63%,在住院期间死亡的31例患者中,也是使用中草药(35.48%)和抗结核药物(19.35%)的患者比例居多。结论急性重症药物性肝损伤致死率较高,其中,中草药和抗结核药物是导致肝损伤以及致死的主要病因,对这两种药物的临床监测需要引起重视。

Retrospective study of incidence condition of acute severe drug-induced liver injury

Objective To retrospectively study the incidence condition of acute severe drug-induced liver injury,and to guide clinical medication.Methods Eighty-two patients with acute severe drug-induced liver injury from May 2003 to May 2013 in Wuzhou Hospital of Traditional Chinese were studied retrospectively.Hospitalization condition and drugs those may cause acute severe liver injury and lethal drugs in patients with acute severe drug-induced liver injury were analyzed.Results Treatment ways of patients included artificialliver treatment （34.15％） and drug treatment alone （65.85％）.Thirty-one patients （37.80％） died during the treatment,30 cases （36.59％） were deterioration,13 cases （15.85％） were improved,8 cases （9.76％） were cured,liver injuries caused by 3 types of drugs were Chinese herbal medicine,anti tuberculosis drugs and antibiotics,the rates were 28.05％,24.39％ and 14.63％,respectively,herbal medicine （35.48％） and anti tuberculosis drugs （19.35％） were the most proportion in the patients died during hospitalization.Conclusion The mortality rate of acute severe drug-induced liver injury is high,among them,the main cause of liver injury and death are Chinese herbal medicine and anti tuberculosis drug,it is should be needed attention on the two kinds of drugs.