论文部分内容阅读
目的探讨药物性肝病在住院患者人群中的发生率、危险因素和可疑药物。方法基于上海市医院住院患者用药数据库中拥有2次及以上ALT记录的患者人群,以用药后ALT>60 U·L~(-1)为药物性肝病的评价标准,采用逐步Logistic回归方法分析年龄、性别、服药种类、住院时间和基线ALT值对药物性肝病发生率的影响,并计算引起药物性肝病的可疑药物的似然比。结果 :纳入研究的3030例患者中药物性肝病有171例,占5.61%。服药种类是其危险因素。药物性肝病的可疑药物涉及各个类别的药物,以中药出现的频次最高,其次为主要抗菌药物。有220种可疑药物可能与药物性肝病有关,其中磺胺甲(?)唑、氯胺酮等似然比较高。结论住院患者在合并使用多种药物和应用磺胺甲(?)唑等具有肝毒性药物时应加强肝功能监测,以避免药物性肝病的发生。
Objective To investigate the incidence, risk factors and suspicious drugs of drug-induced liver disease in hospitalized patients. Methods Based on the population of patients with ALT of two or more records in inpatient drug database of Shanghai hospital, ALT> 60 U · L ~ (-1) after drug use was used as evaluation standard of drug-induced liver disease, and Logistic regression was used to analyze the age , Sex, type of medication, length of stay, and baseline ALT values on the incidence of drug-induced liver disease and to calculate the likelihood ratio of suspected drug-induced liver disease. Results: Of 3030 patients enrolled in the study, there were 171 cases of drug-induced liver disease, accounting for 5.61%. The type of medication is its risk factor. Suspected drugs for drug-induced liver disease involve various categories of drugs, with the highest frequency of occurrence of TCM, followed by the major antimicrobial agents. There are 220 kinds of suspicious drugs may be related to drug-induced liver disease, including sulfamethoxazole, ketamine and other high likelihood. Conclusions Inpatients should strengthen the monitoring of liver function when combining multiple drugs and using sulfa drugs such as sulfamethoxazole, so as to avoid the occurrence of drug-induced liver disease.