论文部分内容阅读
特异质型药物性肝损伤(idiosyncratic drug-induced liver injury,IDILI)是仅在少数人群发生的药物不良反应,其发生往往与服药时间、剂量无明确对应关系,具有不可预测性和发病率低等特点。研究表明,IDILI是机体、环境和药物因素协同作用的结果,而机体免疫是IDILI发生的主要诱因。目前,化学药物诱导的IDILI研究较为广泛和深入,形成了多种免疫学机制假说,较好地阐释了其发病特点和机制。近年来,中药特异质肝损伤也逐步被证实,并且形成了中药特异质肝损伤免疫应激“三因致毒”机制假说,较为全面地揭示了中药IDILI的发病特点和机制。本文就化学药物和中药诱导的IDILI免疫学机制假说进行综述,以期为IDILI评价和临床风险防控对策建立提供科学依据。
Idiosyncratic drug-induced liver injury (IDILI) is an adverse drug reaction that occurs in only a small number of people. The occurrence of idiopathic drug-induced liver injury (IDILI) often has no clear correspondence with time and dose of medication, with unpredictable and low incidence Features. Studies have shown that IDILI is the result of the synergistic effects of the body, environment and drug factors, while the body immunity is the main cause of IDILI. At present, the study of IDILI induced by chemical drugs is more extensive and in-depth, and formed a variety of immunological mechanism hypothesis, which well explained the characteristics and mechanism of IDILI. In recent years, TCM-specific liver injury has also been gradually confirmed, and the formation of a special liver injury of traditional Chinese medicine immune stress “three causes of poisoning ” mechanism hypothesis, a more comprehensive disclosure of the pathogenesis and mechanism of Chinese medicine IDILI. This article reviews the hypotheses of IDILI-induced immunological mechanism induced by chemical drugs and Chinese herbs in order to provide a scientific basis for IDILI evaluation and establishment of clinical risk prevention and control measures.