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目的描述性分析245例药物性肝损伤(DILI)患者临床流行病学特点。方法回顾性分析DILI患者年龄、性别、药物、病理、预后等临床资料。采用SPSS 12.0统计软件,计数资料比较采用χ2检验,计量资料比较采用t检验。P≤0.05为差异有统计学意义。结果 245例DILI患者,男性151例、女性94例(P=0.877);肝细胞型160例(65.30%),胆汁淤积型27例(11.02%),混合型58例(23.67%);G2级87.50%,G3级12.50%;S0级12.50%,S2级50.00%,S3级25.00%,S2~3级12.50%。伴发的基础疾病前3位分别为心血管疾病68例(27.75%)、呼吸系统疾病54例(22.04%)、内分泌疾病30例(12.24%);引起DILI药物最多见的是中药61例(24.90%),其次为心血管药物34例(13.88%)。根据病情停用致病药物或减低致病药物用量及相应保肝对症治疗,治疗后肝功能完全恢复83例(33.88%),好转159例(64.90%);5例重症肝病经综合治疗后,2例治愈,3例因病情较重或其他原因转其他医院进一步治疗,预后不详。结论 DILI临床发病率高,以肝细胞型多见,伴发基础疾病多,中药是最常见致病药物,根据病情停用致病药物或减低致病药物用量及相应保肝对症治疗效果好。
Objective To describe the clinical epidemiological characteristics of 245 patients with drug-induced liver injury (DILI). Methods Retrospective analysis of clinical data of DILI patients such as age, gender, drug, pathology, prognosis. Using SPSS 12.0 statistical software, count data were compared using χ2 test, measurement data were compared using t test. P≤0.05 for the difference was statistically significant. Results A total of 245 patients with DILI were enrolled, 151 males and 94 females (P = 0.877). There were 160 hepatocellular types (65.30%), 27 cholestatic types (11.02%) and 58 mixed type (23.67% 87.50%, G3 grade 12.50%; S0 grade 12.50%, S2 grade 50.00%, S3 grade 25.00%, S2-3 grade 12.50%. The first 3 cases with underlying diseases were 68 cases of cardiovascular diseases (27.75%), respiratory system diseases in 54 cases (22.04%) and endocrine diseases in 30 cases (12.24%). The most common cause of DILI drugs were 61 cases of traditional Chinese medicine 24.90%), followed by cardiovascular drugs in 34 cases (13.88%). 83 cases (33.88%) recovered completely, 159 cases (64.90%) improved liver function after treatment, and 5 cases of severe liver disease after comprehensive treatment, 2 cases were cured, 3 cases due to serious condition or other reasons to other hospitals for further treatment, the prognosis is unknown. Conclusion The clinical incidence of DILI is high. Most of the patients with hepatocellular type are complicated with basic diseases. Traditional Chinese medicine is the most common disease-causing drug. Depending on the disease, the use of pathogenic drugs or the reduction of the amount of causative drugs and the corresponding hepatoprotective effects are good.