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目的分析小儿药物性肝损伤(DILI)的原因及临床特征,旨在指导临床合理用药,降低药物性肝损伤的发生。方法回顾性分析58例小儿药物性肝损伤患儿的临床资料,分析其年龄、临床表现、用药情况、病情严重程度以及预后情况。结果肝细胞型(HC型)重症率为7.14%、胆汁淤积开明(CS型)重症率25.00%、混合型(MIXED型)重症率46.43%,MIXED型重症率多于HC型(P<0.05);转归:HC型预后良好率为85.71%、CS型预后良好率为75.00%、MIXED型预后良好率为85.71%,比较差异无统计学意义(P>0.05)。结论抗菌药物和中药是导致药物性肝损伤最常见的病因,多见MIXED型,多数患儿预后良好。
Objective To analyze the causes and clinical features of pediatric drug-induced liver injury (DILI) in order to guide clinical rational drug use and reduce the occurrence of drug-induced liver injury. Methods The clinical data of 58 children with drug-induced liver injury were retrospectively analyzed. The age, clinical manifestations, drug use, severity of illness and prognosis were analyzed. Results The rates of severe hepatocellular (HC) type were 7.14%, severe CS (25.00%), severe type 46 (46.43%) were MIXED type, severe type MIXED type (P <0.05) The prognosis of HC type was 85.71%. The good prognosis of CS type was 75.00%. The good prognosis of MIXED type was 85.71%. There was no significant difference between the two groups (P> 0.05). Conclusion Antimicrobial drugs and traditional Chinese medicine are the most common causes of drug-induced liver injury, more common type MIXED, most children with good prognosis.