128例藥物性肝病分析(1)
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[摘要] 目的 對(duì)藥物性肝病的臨床特點(diǎn)進(jìn)行分析。 方法 回顧性分析128例藥物性肝病患者的臨床資料。 結(jié)果 導(dǎo)致藥物性肝病的藥物種類繁多，其中中草藥及中成藥(25.00%)、抗結(jié)核藥(20.31%)所占比例最多；肝細(xì)胞型患者75例，膽汁淤滯型36例，混合型17例；128例患者發(fā)病時(shí)間，<1周患者5例，1~5周患者11例，6~12周患者46例，13~19周患者35例，20~26周患者7例，27~33周患者15例，>33周患者9例；115例患者預(yù)后良好，其余13例預(yù)后欠佳，其中12例發(fā)生重型肝炎，1例死亡。 結(jié)論 中草藥及中成藥和抗結(jié)核藥是引起藥物性肝病的主要藥物，應(yīng)定期檢測(cè)肝功能。
[關(guān)鍵詞] 藥物性肝病；臨床特點(diǎn)；分析；中藥
[中圖分類號(hào)] R575 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-4721(2012)02(a)-0021-02
Clinical analysis of 128 cases with drug-induced liver disease
HU Zhiming
Department of Gastroenterology, People's Hospital of Taojiang County in Hunan Province, Taojiang 413400, China
[Abstract] Objective To study the clinical features of drug-induced liver disease. Methods The clinical data of 128 cases with drug-induced liver disease were retrospectively analyzed. Results There were various drugs which could result in drug-induced liver disease, with the traditional Chinese medicines (25.00%) and anti-tuberculosis drugs (20.31%) taking the maximum of proportion. There were 75 cases with liver cell type, 36 cases with bile stasis type, and 17 cases with the mixed type. As to the onset time, there were 5 cases (< 1 week), 11 cases (1-5 week), 46 cases (6-12 week), 35 cases(13-19 week), 7 cases (20-26 week), 15 cases (27-33 week) and 9 cases (> 33 week). 115 cases had good prognosis, while the other 13 cases had bad prognosis including 12 patients with severe hepatitis and one death. Conclusion Traditional Chinese medicines and anti-tuberculosis drugs are the main kinds of drugs, which can cause drug-induced liver disease, and the liver function of patients taking these drugs should be regularly detected.
[Key words] Drug-induced liver disease; Clinical features; Analysis; Traditional Chinese medicine
藥物性肝病(Drug-induced liver disease)在臨床上表現(xiàn)癥狀多樣，可表現(xiàn)為發(fā)熱、皮疹、黃疸以及轉(zhuǎn)氨酶升高等，部分患者甚至?xí)霈F(xiàn)急性肝功能衰竭等較為嚴(yán)重的并發(fā)癥；在西方國(guó)家,由藥物引起的急性肝功能衰竭占全部肝功能衰竭患者的10%～52%。有文獻(xiàn)報(bào)道顯示，藥物性肝病占所有藥物損害病例的10%～15%[1]。由于藥物性肝病臨床表現(xiàn)較為復(fù)雜，實(shí)驗(yàn)室檢查又缺乏特異性，因此常常易導(dǎo)致漏診、誤治。現(xiàn)對(duì)本院2002年1月～2010年12月收治入院的128例藥物性肝病患者的臨床資料進(jìn)行分析，報(bào)道如下：
1資料與方法
1.1一般資料
本組患者128例，均為本院于2002年1月～2010年12月收治的患者，所有患者均符合藥物性肝病診斷標(biāo)準(zhǔn)[2] ......
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