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目的回顾性调查我国多中心急性药物性肝损伤住院患者的诊治情况,对急性药物性肝损伤病例进行关联性评价。方法收集全国13个地区16家大型医院2000年至2005年期间因急性药物性肝损伤住院病例及其肝损伤病史和住院诊治经过。采用急性药物性肝损伤国际共识意见的量化评分系统.评价药物与肝损伤的相关程度并列出可能导致急性药物性肝损伤的主要药物。结果全国16家医院报告的急性药物肝损伤5年间住院诊治数共1541例,住院病例有逐渐增加趋势。在可供进行关联性评价的1204例中,急性药物性肝损伤与药物之间的关联性程度及其比例依次为:极有可能(评分>8分)占14.3%.很可能有关(6～8分)占39.6%,可能有关(3～5分)占40.9%,可能无关(1～2分)占3.8%,无关(≤0分)占1.3%。在药物与肝损伤相关的1142例中,男女比例接近,平均年龄(45.7±16.7)岁,重症药物性肝损伤76例(6.65%),死亡17例,病死率1.5%。导致急性肝损伤的药物种类繁多。其中以中成药或中草药(21.5%)和抗结核药物(21.2%)为多见。结论我国急性药物性肝损伤住院诊断病例数有逐年增加趋势,国际共识意见的量化评分系统有助于重新审定急性肝损伤与药物之间的关联程度,抗结核药物和中成药或中草药可能是我国急性药物性肝损伤的主要病因。
Objective To retrospectively investigate the diagnosis and treatment of inpatients with multicentre acute drug-induced liver injury in our country and to evaluate the relevance of acute drug-induced liver injury. Methods A total of 16 large hospitals in 13 regions of China were collected from 2000 to 2005 for hospitalization for acute drug-induced liver injury and their history of liver injury and hospitalization. A quantitative scoring system that adopts the internationally agreed opinion of acute drug-induced liver injury to assess the extent of drug-liver damage and list the major drugs that may cause acute drug-induced liver injury. Results A total of 1541 hospitalized cases of acute liver injury were reported in 16 hospitals nationwide in 5 years. The incidence of inpatients was gradually increasing. Among the 1204 cases that can be used to evaluate the relevance, the degree and proportion of acute drug-induced liver injury and drug are as follows: it is highly probable (score> 8 points) accounted for 14.3% 8 points) accounted for 39.6%, possibly related to (3 to 5 points) 40.9%, possibly unrelated (1 to 2 points) accounted for 3.8%, unrelated (≤ 0 points) accounted for 1.3%. Among 1142 cases of drug-related liver injury, the ratio of male to female was close, with an average age of (45.7 ± 16.7) years, 76 cases of severe drug-induced liver injury (6.65%), 17 deaths and a case fatality rate of 1.5%. A wide range of drugs that cause acute liver damage. Among them, proprietary Chinese medicines or Chinese herbal medicines (21.5%) and anti-tuberculosis drugs (21.2%) are more common. Conclusions The number of inpatient diagnosis of acute drug-induced liver injury in our country increases year by year. The quantitative assessment system of international consensus opinions can help to re-examine the correlation between acute liver injury and drugs. Anti-TB drugs and proprietary Chinese medicines The main cause of acute drug-induced liver injury.