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药物性肝功能损伤的临床特征及影响因素分析

作者：许新1 2 纪莉莎 3 陈丽丽 3 董全勇 1 2 李晓琳 1 2 张楠楠 1 2 辛永宁 2 4 宣世英 2 4

单位：1. 大连医科大学辽宁大连 116044 2. 青岛市市立医院消化内二科山东青岛 266021 3. 青岛市市立医院内镜中心山东青岛 266021 4. 青岛市消化疾病重点实验室山东青岛 266021

关键词：药物性肝功能损伤临床特征影响因素

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出版年,卷(期):页码：2016,8(1):49-52

摘要：

摘要：目的分析药物性肝功能损伤的临床特征及影响因素，为临床合理用药提供参考。方法查阅
2012年1月至2014年12月期间收治入院并确诊为药物性肝功能损伤的178例患者的病历，对患者的临
床资料进行回顾性分析。结果多数患者出现不同程度乏力、食欲不振、恶心、呕吐、腹胀等临床症
状（89.9%），少数患者出现发热（20.2%）、皮肤瘙痒（16.8%）和皮疹（13.5%），肝功能损伤发
生在用药2周内最多（65.9%），以肝细胞型最多见（49.7%）。致病药物多为中药、抗肿瘤药、抗结
核药、抗生素、解热镇痛药等。以口服药物途径最常见。经保肝、降酶、退黄等治疗后患者恢复良
好，治愈好转率为87.6%。结论影响药物性肝功能损伤因素众多，有年龄、药物种类、用药时间、联
合用药、基础肝病等，临床上应对其引起足够重视，加强用药安全意识，以减少药物性肝功能损伤
的发生。

Abstract: Objective To analyze the clinical features and influence factors of drug-induced liver injury
(DILI) and to provide a reference for clinical medication. Methods The medical records of 178 hospitalized
DILI patients from January 2012 to December 2014 were consulted and the clinical data were analyzed
retrospectively. Results Most patients had lack of power, poor appetite, nausea, vomit, abdominal distension,
ect (89.9%), a few patients had a fever (20.2%), pruritus (16.8%) and rash (13.5%). Liver damage occurred
within 2 weeks (65.9%) and the liver cell type was the most common damage(49.7%). Most of the causative
drugs were Chinese medicine, antineoplastic drugs, anti-TB drugs, antibiotics, antipyretic analgesics, etc. The
most common administration way was oral. After treatment, patients recovered well and the curative rate
was 87.6%. Conclusions Many factors can affect DILI, such as age, types of drugs, medication time, drug
combination, basic liver diseases, ect. Clinicians should pay enough attention to DILI and strengthen the safety
medication awareness to reduce the occurrence.

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