药物性肝损害279例分析

目的:探讨药物性肝损害的致病药物及特点。方法:对某院2003－2013年期间的279例药物性肝损害进行回顾性分析。结果:在279例药物性肝损害患者中,男性140人,女性139人,严重肝功能损害50例;联合用药93例,单一用药186例。患者疾病种类包括肿瘤、呼吸系统感染、代谢综合征等。其中,药物性肝损害中肝细胞损害型占62%(173例)。怀疑药物196种,其中中药占17.81%,抗肿瘤药占16.44%,心血管药占10.68%,抗结核药占10.41%。最常见怀疑药物包括异烟肼、利福平、甲巯咪唑、雷公藤片。抗肿瘤、抗结核与非甾体抗炎药物参与联合用药时药物性肝损发生例数多于单用。结论:易引发药物性肝损害的药物有中药类、抗菌药物类、抗肿瘤药物、抗心血管药物与抗结核药物。联合用药对药物性肝损发生有一定的影响,值得人们进一步开展研究。

Analysis of 279 cases with drug induced liver injury

OBJECTIVE To explore drugs which could induce liver injury and their clinic features.METHODS From 2003 to 2013 in our hospital, 279 cases of drug-induced liver injury were analyzed retrospectively.RESULTS Of 279 patients who developed DILI,140 were males and 139 were females,and 50 were diagnosed as severe DILI.There were 93 patients treated with combined drugs and 186 patients received single drug treatment.The underlying diseases of patients with DILI included cancer,respiratory tract infections,metabolism syndrome,etc.Sixty-two percent (n=173) of DILI were categorized as hepatocellular.There were 196 suspected drugs,most of them were traditional Chinese drugs (17.81%), antineoplastic agents (16.44%),cardiovascular drugs (10.68%),antituberculosis drugs (10.41%).The most common suspected drugs resulting in DILI included isoniazid,rifampicin,thiamazole,thunder god vine tablets.As shown in our data,DILI patients treated with combined drugs (antineoplastic agents, antituberculosis and nonsteroidal antiinflammatory drugs) were more than those treated with single drugs.CONCLUSION The most common drugs resulting in DILI include traditional Chinese drugs,antibiotics,antitumor agents,cardiovascular drugs and antituberculosis drugs.Combined drug treatment can influence the incidence of DILI,which is worthy to be further studied.