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目的分析药物性肝病的病因、临床特点及评价诊断正确性,以提高对该病的认识,及早做出正确诊断并治疗。方法对228例药物性肝病患者的临床资料进行分析,并根据国际共识会议诊断标准进行关联性评价。结果引起肝病的主要药物为抗结核药33.8%(77/228),中草药24.6%(56/228)。临床表现以黄疸多见。临床分型以肝细胞型为主,占62.6%(119/190)。关联性评价结果:药物相关性肝损伤69例(36.3%),药物不相关性肝损伤25例(13.2%),未能确定病因的肝损伤96例(50.5%)。结论引起药物性肝病的药物以抗结核药和中草药常见,临床分型以肝细胞为主。国际共识会议诊断标准有助于肯定或排除药物性肝病,但本组资料中仍有50.5%病例为疑似状态,现行的临床诊断方法尚有待改进。
Objective To analyze the etiology, clinical features and diagnostic accuracy of drug-induced liver disease so as to improve the understanding of the disease and make correct diagnosis and treatment as soon as possible. Methods The clinical data of 228 patients with drug-induced liver disease were analyzed, and the relevance was evaluated according to the diagnostic criteria of international consensus conference. Results The main drugs for liver diseases were 33.8% (77/228) of antituberculosis drugs and 24.6% (56/228) of Chinese herbal medicines. Clinical manifestations of jaundice more common. The main clinical type of hepatocyte type, accounting for 62.6% (119/190). Relevance of the evaluation results: 69 cases (36.3%) of drug-related liver injury, 25 cases (13.2%) of drug-unrelated liver injury, 96 cases (50.5%) of liver failure without the etiology. Conclusions Drugs causing drug-induced liver disease are commonly seen in anti-TB drugs and Chinese herbal medicines. The main clinical types are hepatocytes. Diagnostic criteria of the international consensus conference help to confirm or rule out drug-induced liver disease, but in this group of data there are still 50.5% of cases suspected, the current clinical diagnostic methods still need to be improved.