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目的评估药物淋巴细胞刺激试验(drug lymphocyte stimulation test,DLST)对药物性肝损伤(Drug induced liver injury,DILI)临床诊断的意义。方法对84例临床诊断为DILI、17例疑诊、17例有服药史的非DILI患者行DLST检测,结合其人口学资料、临床分型、临床生化指标等进行非随机对照的回顾性分析,进一步评价DLST在临床的应用价值。结果 101例临床诊断或疑诊DILI患者中,共36例DLST阳性,DLST特异度为98.6%,在所有DILI患者中(包括过敏特异质和遗传特异质)敏感度35.6%。DLST阳性与RUCAM有较好的相关性(P=0.015)。结论药物淋巴细胞刺激试验对药物导致的肝损伤具有较高的诊断特异性,结合RUCAM评分可提高DILI的诊断标准性。
Objective To evaluate the clinical significance of drug-induced liver injury (DILI) by drug lymphocyte stimulation test (DLST). Methods A total of 84 cases of non-DILI patients with DILI, 17 suspected cases and 17 cases with medication history were retrospectively analyzed by DLST in combination with their demographic data, clinical classification and clinical biochemical indexes. To further evaluate the clinical value of DLST. Results Of the 101 clinically diagnosed or suspected DILI patients, a total of 36 cases were positive for DLST with a DLST specificity of 98.6% and a sensitivity of 35.6% in all DILI patients (including both allergen-specific and hereditary-specific). There was a good correlation between DLST positive and RUCAM (P = 0.015). Conclusion The drug-induced lymphocyte stimulation test has high diagnostic specificity for drug-induced liver injury. Combined with RUCAM score, it can improve the diagnostic standard of DILI.