摘要
目的探讨药物性肝损伤(DILI)患者的用药情况及临床特征。方法采用回顾性研究的方法,对该院2014-2018年收治的127例确诊为DILI患者的临床资料进行整理、统计、分析。结果在127例DILI患者中,40~<50岁、50~<60岁两年龄段人数最多,共59例,占46.45%。西药引起的DILI比例最高(69.85%),其中,以调节血脂药所占比重最大(12.50%),其次为解热镇痛抗炎药、降糖药,均为6.62%;引起DILI的给药途径中,以口服途径发生率最高(91.34%)。60例DILI患者实验室检查指标升高,而无肝损害相关临床症状。实验室检查结果以丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)升高为主,部分患者碱性磷酸酶(ALP)、谷氨酰转移酶(GGT)、总胆红素(TBIL)、直接胆红素(DBIL)、间接胆红素(IBIL)也有升高。109例患者在停药和对症治疗后好转。结论临床医务人员应了解DILI发生的特点及规律,在用药的同时注意监测肝功能的变化,一旦确诊为DILI,应权衡利弊,考虑停药,积极对症治疗。
Objective To investigate the medication situation and characteristics of drug induced liver injury.Methods A total of 127 cases diagnosed as drug-induced liver injury were selected from 2014 to 2018 in our hospital,and these cases were analyzed retrospectively.Results The patients aged 40-<50,50-<60 years(59 cases)accounted for 46.45%of all the patients.Western medicine which induced drug-induced liver injury cases accounted for 69.85%and lipid-lowering drugs was the largest share(12.50%),followed by antipyretic analgesics(6.62%)and antidiabetic drugs(6.62%).The most common route was oral administration,accounting for 91.34%.Totally 60 cases showed laboratory indexes had risen,but they didn't have related symptoms.The rising of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were significant characteristics of laboratory examination,part of patients had showed the increase of alkaline phosphatase(ALP),glutamyltransferase(GGT),total bilirubin(TBIL),direct bilirubin(DBIL),indirect bilirubin(IBIL).A total of 109 patients recovered after discontinuation and symptomatic treatment.Conclusion Clinical medical staff should understand the characteristics and regularity of liver damage caused by various drugs.Liver function should be monitored when using drugs with high incidence of drug-induced liver damage.Once the patients have been diagnosed as drug liver damage,pros and cons should be balanced,meanwhile the drug should be considered withdrawn,treatment should be taken actively.
作者
王全华
付辛芳
虢艳宁
吴爽爽
席宇菁
郭建芳
张萍
杨建婷
WANG Quanhua;FU Xinfang;GUO Yanning;WU Shuangshuang;XI Yujing;GUO Jianfang;ZHANG Ping;YANG Jianting(Institute of Hygienic Research in Ordnance Industry,Xi'an 710065,China)
出处
《检验医学与临床》
CAS
2019年第24期3623-3626,共4页
Laboratory Medicine and Clinic
关键词
药物性肝损伤
回顾分析
肝功能
drug-induced liver injury
retrospective analysis
liver function
作者简介
王全华,女,主管药师,主要从事临床药学方面的研究;通信作者:杨建婷,E-mail:373239978@qq.com.
