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目的:了解引起老年患者药源性肝损害的情况,并分析相关因素为减少药源性肝损害,临床安全用药提供参考。方法:采用回顾性研究方法,从国家药品不良反应监测中心2009~2010年收集到的老年患者严重药品不良反应病例报告中发生肝损害的病例,对患者一般情况、引起肝损害的药品、给药途径、临床表现进行统计分析。结果:引起老年患者肝损害的药物涉及15大类药物,前5位的是抗感染药物、心血管系统用药、神经系统用药、中药制剂和抗肿瘤药。引起10例以上肝损害的药品有16种。发生药源性肝损害的最常见给药途径是口服给药,占62.36%。肝损害发生时间差异较大,最短的1 d,长的超过1年。发生肝损害老年患者58.39%无临床症状,其余41.61%老年患者的临床表现以黄疸、纳差、乏力倦怠为主。实验室检查以ALT异常为主,占97.31%,大部分老年患者(94.64%)在停药和对症治疗后治愈或好转。结论:老年患者肝损害可由多种药物引起,长期用药的老年患者定期监测肝功能有利于及早发现肝损害,及时停用肝损害药物是治疗的关键。
Objective: To understand the drug-induced liver damage caused by elderly patients, and to analyze the relevant factors for the reduction of drug-induced liver damage, clinical safety medication to provide a reference. Methods: A retrospective study was conducted to investigate the incidence of liver damage in elderly patients with serious adverse drug reactions collected from 2009 to 2010 by the National Agency for Adverse Drug Reactions Monitoring. In the general case of patients, drugs that cause liver damage, Ways, clinical manifestations for statistical analysis. RESULTS: The drugs that cause liver damage in elderly patients involved 15 categories of drugs, the top 5 were anti-infectives, cardiovascular system drugs, nervous system drugs, traditional Chinese medicine preparations and antineoplastic drugs. There are 16 kinds of drugs that cause more than 10 cases of liver damage. The most common route of administration for drug-induced liver damage is oral administration, accounting for 62.36%. The time of liver damage varies greatly, the shortest 1 d, longer than 1 year. The incidence of liver damage in elderly patients 58.39% no clinical symptoms, the remaining 41.61% of elderly patients with jaundice, anorexia, fatigue fatigue-based. The main laboratory abnormalities were ALT, accounting for 97.31%. The majority of elderly patients (94.64%) were cured or improved after withdrawal and symptomatic treatment. Conclusion: Liver damage in elderly patients can be caused by a variety of drugs. Long-term use of drugs in elderly patients to monitor liver function on a regular basis is beneficial to detect liver damage as soon as possible and promptly disable the drug for liver damage is the key to treatment.