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目的:探讨非甾体类抗炎药（NSAID）所致肝损伤的临床病理特点。方法:检索石家庄市第五医院信息系统，收集2013年1月1日至2016年12月31日出院诊断含药物性肝损伤（DILI）患者的病历资料进行回顾性分析。将NSAID所致肝损伤患者纳入NSAID组，其他药物所致肝损伤患者纳入对照组。记录2组患者的一般情况、实验室检测结果和肝组织病理学检查结果。由本研究团队成员根据相关标准重新统一进行Roussel Uclaf因果关系评估法（RUCAM）评分、临床分型分级、病理学分型分级和临床转归评价。结果:纳入分析的患者共385例，NSAID组63例，对照组322例。2组患者的性别、年龄、临床表现等差异均无统计学意义（均n P>0.05）。依据R值对DILI分型和肝损伤严重程度分级的结果显示，2组患者中不同类型肝损伤者占比和不同级别肝损伤者占比差异均无统计学意义（均n P>0.05）。NSAID组和对照组行肝活检者分别为41和142例，结果显示，NSAID组血管损伤型者占比高于对照组[4.9%（2/41）比0（0/142），n χn 2=7.003，n P=0.049]，汇管区炎症发生率和细胆管增生发生率均明显低于对照组[63.4%（26/41）比93.7%（133/142），n χn 2=25.544，n P0.05 for all). The results of types and severity classification of DILI based on R value showed that the differences of the proportion of patients with different DILI types and classifications between the 2 groups were not statistically significant (n P>0.05 for all). Forty-one and 142 patients underwent liver biopsy in the NSNIDs group and the control group, respectively. The results of liver biopsy showed that the proportion of patients with type of vascular injury in the NSAIDs group was significantly higher than that in the control group [4.9% (2/41) n vs. 0 (0/142), n χn 2=7.003, n P=0.049]; the incidences of inflammation in the portal area and proliferation of bile duct in the NSAIDs group were statistically lower than those in the control group [(63.4%(26/41) n vs. 93.7%(133/142), n χn 2=25.544, n P<0.001; 43.9%(18/41) n vs. 76.1%(108/142); n χn 2=15.337, n P0.05]. There were no death in both groups.n Conclusions:The clinical manifestations and clinical outcomes of patients with DILI due to NSAIDs were similar to those due to other drugs. The pathological characteristics of liver were that the incidence of inflammation and proliferation of bile duct in the portal area was lower than that of other drugs, and the incidence of hepatocyte steatosis was higher than that of other drugs. Vascular injury was also observed.