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目的 分析51例药物性肝病的病因和临床特点,以加深临床医师对药物性肝病的认识。方法 根据患者服药史、临床表现、血象、肝功能实验、血清标志以及停药后的效应作出综合判断。结果 引起肝病的有关药物中,抗结核病药占25 .5%,解热镇痛抗炎药占21. 6%,中草药类占11. 8%,抗菌药占9 .8%,抗肿瘤类药占5. 9%。其它类药包括性激素类、镇静催眠药、抗真菌药、抗精神病药、抗癫痫药、降血糖药、抗甲状腺药、调血脂药、驱虫药、减肥药等。临床病理分型:49例急性药物性肝病,其中肝细胞损伤型(包括肝炎型、脂肪肝型)39 例,胆汁淤积型4例,混合型6例;慢性药物性肝病2例。经停药后治疗,大部分病例痊愈,2 例亚急性重症肝炎患者死亡。结论 临床医师应重视药物性肝病的预防、诊断和治疗。
Objective To analyze the etiology and clinical features of 51 cases of drug-induced liver disease in order to deepen the understanding of clinicians on drug-induced liver disease. Methods According to the patients taking history, clinical manifestations, blood, liver function tests, serum markers and the effect of withdrawal after a comprehensive judgment. The results of the drug causing liver disease, anti-tuberculosis drugs accounted for 25.5%, anti-inflammatory analgesic anti-inflammatory drugs accounted for 21.6%, Chinese herbal medicines accounted for 11.8%, antibacterial drugs accounted for 9.8%, anti-tumor drugs Accounting for 5.9%. Other classes of drugs include sex hormones, sedatives and hypnotics, antifungals, antipsychotics, antiepileptics, hypoglycemic agents, antithyroid drugs, blood lipid lowering agents, deworming agents, diet pills and more. Clinicopathological classification: 49 cases of acute drug-induced liver disease, including liver cell injury (including hepatitis type, fatty liver type) in 39 cases, 4 cases of cholestasis, mixed type in 6 cases; 2 cases of chronic drug-induced liver disease. After discontinuation of treatment, most cases were cured, 2 patients died of subacute severe hepatitis. Conclusion Clinicians should pay attention to the prevention, diagnosis and treatment of drug-induced liver disease.