论文部分内容阅读
药物性肝病病理表现多种多样,肝内所有细胞均会受到药物的影响,而所有类型的肝损伤均可由药物引起。急性肝炎是最常见类型,又分为急性肝细胞性肝炎、急性胆汁淤积,混和型急性肝炎。此外还可出现急性肝坏死、慢性肝炎和(或)肝硬化、肉芽肿性肝炎、脂肪肝、血管损害、胆小管损伤的急慢性胆管炎、甚至肿瘤。 出现药物性肝损伤的危险性受到许多获得和遗传性因素影响,在诊断时应予以考虑。获得性因素包括年龄(超过60岁可能促进异烟肼、呋喃坦啶引起的肝炎,而儿童易于出现丙戊酸和水杨酸盐引起的肝毒性,特别是水杨酸盐常诱导小囊泡性脂肪肝和Reye’s综合征)、性别(女性较男性更容易出现甲基多巴和呋喃坦啶引起的肝毒性,而男性易于出现硫唑嘌呤诱导的肝损伤)、营养状态(肥胖促进氟烷引起的肝毒性,而禁食和营
Pathological manifestations of drug-induced liver disease varied, all cells in the liver are affected by the drug, and all types of liver damage can be caused by the drug. Acute hepatitis is the most common type, is divided into acute hepatocellular hepatitis, acute cholestasis, mixed acute hepatitis. In addition, there may be acute liver necrosis, chronic hepatitis and / or cirrhosis, granulomatous hepatitis, fatty liver, vascular damage, acute and chronic cholangitis with tubule injury, and even tumors. The risk of developing drug-induced liver injury is influenced by many acquired and hereditary factors and should be considered at the time of diagnosis. Acquired factors include age (over 60 years of age may promote hepatitis due to isoniazid, furadantin, and children are prone to hepatotoxicity due to valproate and salicylate, especially salicylate often inducing vesicles Sexual Fatty Liver and Reye’s Syndrome), Sex (Women are more likely to develop hepatotoxicity due to methyldopa and furilamine than men, while men are prone to azathioprine-induced liver injury), Nutritional status (obesity-promoting halothane Caused by liver toxicity, while fasting and battalion