药物引起的肝损伤发病机制研究进展

药物性肝损伤(drug-induced liver injury, DILI)是由药物或其代谢产物乃至辅料所引起的肝损伤，是目前临床上常见的药品不良反应之一。药物性肝损伤在我国的发生率偏高，仅次于病毒性肝炎和脂肪性肝病。在欧美，药物性肝损伤是引发肝衰竭的主要原因。尽管人们早已意识到药物性肝损伤的危害，但由于其病因复杂，临床表现不具有特异性，诊断标记物特异性不强，导致药物性肝损伤患者常常无法及时被确诊，最终发展为肝衰竭甚至死亡。已知目前有超过1 100种药物可以在不同程度上引起肝损伤。因此，本文主要总结了不同类型药物诱发肝损伤的不同作用机制，为日后药物性肝损伤的预防和治疗提供了一定的理论基础。

Research progress on the pathogenesis of drug-induced liver injury caused by different drugs

Drug-induced liver injury(DILI) is caused by drugs or their metabolites or excipients, which is one of the common adverse drug reactions in clinical practice. DILI has a high incidence in China, second only to viral hepatitis and fatty liver disease. DILI is a leading cause of liver failure in Europe and the United States. Although people have long been aware of the harm of drug-induced liver injury, due to its complex etiology, non-specific clinical manifestations and weak specificity of diagnostic markers, patients with drug-induced liver injury often cannot be diagnosed in time and eventually develop liver failure or even death. More than 1 100 drugs are known to cause liver damage to varying degrees. Therefore, this paper reviewed the pathogenesis of drug-induced liver injury from the perspective of etiology, hoping to give readers a more comprehensive and in-depth understanding of DILI.