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目的探讨药物性肝损伤(drug-induced liver injury,DILI)的临床特点,为临床早期诊断和治疗提供依据。方法回顾性分析2005年1月至2009年6月79例DILI住院患者的临床资料。结果79例DILI中男性23例,女性56例(1∶2.43);年龄28～87岁,平均为50.4岁。中药致DILI最常见,其次分别为抗生素、抗结核药、解热镇痛药、抗肿瘤药及保健药。发病潜伏期为8d～半年,服抗生素出现DILI的潜伏期最短,其次为解热镇痛药和抗癌药。而中药、抗结核药、降压药、调脂药及保健药等潜伏期较长。68.4%为肝细胞损伤型,10.1%为胆汁瘀积型,21.5%为混合型。治疗结果70例好转,6例痊愈,2例未愈,1例死亡。结论多种药物长期大量应用均可引起DILI,一旦发现应及时对症治疗并定期复查肝功能。
Objective To investigate the clinical features of drug-induced liver injury (DILI) and provide the basis for early clinical diagnosis and treatment. Methods The clinical data of 79 DILI inpatients from January 2005 to June 2009 were retrospectively analyzed. Results 79 cases of DILI in 23 males and 56 females (1: 2.43); aged 28 to 87 years, with an average of 50.4 years old. Traditional Chinese medicine to DILI the most common, followed by antibiotics, anti-TB drugs, antipyretic analgesics, anti-cancer drugs and health medicine. Incidence of incubation period of 8d ~ six months, the shortest incubation period of antibiotic DILI, followed by antipyretic analgesics and anti-cancer drugs. The traditional Chinese medicine, anti-TB drugs, antihypertensive drugs, lipid-lowering drugs and health drugs longer incubation period. 68.4% were hepatocellular injury type, 10.1% were bile stasis type and 21.5% were mixed type. Treatment of 70 cases improved, 6 cases recovered, 2 cases healed, 1 case of death. Conclusion A large number of long-term use of various drugs can cause DILI, once found symptomatic treatment should be promptly reviewed and liver function.