老年药物性肝病的临床特点

目的 探讨引起老年性药物性肝病的药物种类、临床特点及防治原则.方法 对2006年1月~2011年10月我院120例发生药物性肝病的老年住院患者的临床病历资料进行回顾性分析.结果 老年患者联合用药多,易出现肝损伤,以心血管药物最多,构成比为41.7%（50/120）,其次为抗肿瘤药物,构成比为18.3%（22/120）,再次为抗生素,构成比为15.0%（18/120）;主要临床症状为疲乏、纳差、恶心、呕吐,构成比为25.0%（30/120）,黄疸构成比为11.7%（14/120）,低热构成比为10.0%（12/120）,皮肤瘙痒构成比为8.3%（10/120）,无症状者构成比为45.0%（54/120）;临床治愈率为71.7%.结论 心血管疾病药物、抗肿瘤药物和抗生素是引起老年药物性肝病的常见药物.老年患者肝功能损害后大多无明显症状,老年药物性肝病与其肝脏药物代谢酶活性降低及长期联合用药有关.

Clinical analysis of drug induced liver disease in the elderly

Objective To investigate the clinical features of drug induced liver disease （DILD） in the elderly. Meth- ods Retrospective analysis was used to study the clinical data obtained from the 120 elderly patients with DILD from January 2006 to October 2011. Results The elderly often took several kinds of medicine simultaneously. Among the causative agents, cardiovascular drugs were the most common ones, followed by antineoplastics and the third was an- tibiotics. The main clinical symptoms of DILD were as follows： fatigue, anorexia, nausea, vomiting and jaundice. Whereas the asymptomatic patients were 45.0%. Clinical cure rate was 71.7% without any cases of hepatic failure. Conclusion The common agents which caused the elderly to develop hepatic injury were cardiovascular drugs, anti- neoplastics and antibiotics. Most of the patients were asymptomatic. The lower activity of liver metabolic enzyme and the long term combination of drugs were associated with the liver injury in the elderly.