94例药物性肝损害不良反应分析

目的探讨药物性肝损害的临床特点和致病药物,以期对药物性肝损害的防治提供参考。方法采用回顾性分析方法,对本院2010年1月至2012年12月各临床科室上报的94例药物性肝损害病例进行统计分析。结果 94例药物性肝损害中男56例,女36例;年龄最小2岁,最大86岁,平均49.82(±16.32);既往有药物过敏史24例(25.53%)、既往有肝病史8例(8.51%);涉及药物55种,降脂药物居首位(31.92%)、抗菌药物第二位(20.21%)、解热镇痛药和神经系统用药占第三位(9.57%);临床分型:肝细胞型61例(64.89%)、胆汁淤积型19例(21.27%)、混合型14例(14.89%);临床表现以乏力、纳差、恶心、呕吐等不同程度的胃肠道反应多见;潜伏期1～4周。结论药物性肝损害的药物种类较多,且大部分病例起病隐匿。用药期间定期检查肝功能,及时停药是减轻药源性肝损害的主要措施。

Analysis of 94 Cases of Drug-induced Liver Injury

Objective To analyze clinical features and causative agents of drug-induced liver injury and provide reference for clinical use accordingly. Methods Ninety-four cases of drug-induced liver injury from clinical reports in our hospital from Jan 2010 to Dec 2012 were collected and analyzed retrospectively. Results The average age was 49.82±16.32 years old（from 2 to 86y） in the 94 patients including male 56 and female 36 cases. In their previous histories, there were drug allergies in 24 cases（25.53%） and liver diseases in 8 cases（8.51%）. Fifty-five kinds of drugs were involved in the 94 drug-induced liver injury cases in which lipid-lowering drugs ranked first（31.92%）, antibiotics ranked second （20.21%） and antipyretic analgesics and nervous system drugs ranked third（9.57%）. The clinical types of drug-induced liver injury in these cases included liver cell type in 61 cases（64.89%）, cholestasis type in 19 cases（21.27%） and mixed type in 14 cases（14.89%）. More common in varying degrees of clinical manifestations were fatigue, anorexia, nausea, vomiting and other gastrointestinal reactions. The latent period was 1-4 weeks. Conclusion The types of drug-induced liver injury drugs are diversed. During the course of medication, regularly checking liver function and discontinuing medication are the main measures to reduce drug-induced liver injury