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目的探讨急性药物性肝病的常见诱发药物、临床表现、分型及预后,以提高对该病的诊断水平。方法对符合诊断标准的72例急性药物性肝病的临床资料进行回顾性分析。结果诱发急性药物性肝病的药物中,抗结核药18例(25%),中草药16例(22·2%),抗生素10例(13·9%),抗肿瘤化疗药物4例(5·6%),抗甲亢药4例(5·6%),其他20例(27·8%)。临床表现为急性肝细胞型47例(65·2%),急性胆汁淤积型16例(22·2%),混合型9例(12·5%)。其中治愈52例(72·2%),好转13例(18·1%),无变化5例(6·9%),恶化2例(2·8%)。结论急性药物性肝病常见的诱发药的前五位为抗结核药、中草药、抗生素、化疗药和抗甲亢药等,应该引起临床医生的足够重视。
Objective To investigate the common drugs induced by acute drug-induced liver disease, clinical manifestations, classification and prognosis in order to improve the diagnosis of the disease. Methods The clinical data of 72 cases with acute drug-induced liver disease meeting the diagnostic criteria were retrospectively analyzed. Results Among the drugs that induced acute drug-induced liver disease, 18 (25%) were anti-tuberculosis drugs, 16 (22.2%) were Chinese herbal medicines, 10 (13.9%) were antibiotics and 4 %), Antihypertensive drugs in 4 cases (5.6%), the other 20 cases (27.8%). The clinical manifestations were acute hepatocellular type in 47 cases (65.2%), acute cholestatic type in 16 cases (22.2%) and mixed type in 9 cases (12.5%). Among them, 52 (72.2%) were cured, 13 (18.1%) were improved, 5 (6.9%) were unchanged, and 2 were worse (2.8%). Conclusion The top five induceants of acute drug-induced liver disease are anti-TB drugs, Chinese herbal medicine, antibiotics, chemotherapy drugs and anti-hyperthyroidism drugs, which should be paid enough attention by clinicians.