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目的探讨慢性药物性胆汁淤积性肝病的病因、临床特点及对治疗应答的影响。方法 2011年1月~2013年12月在我院住院治疗的慢性药物性肝损伤(DILl)患者87例,其中23例呈胆汁淤积性肝病(CLD)表现,不伴有胆汁淤积症的慢性DILI患者64例,比较两组临床资料的异同。结果在23例CLD患者中,肝细胞型11例、胆汁淤积型7例、混合型5例,在64例DILI患者中,肝细胞型50例,胆汁淤积型4例,混合型10例,两组临床分型差异具有统计学意义(P<0.01);引起两组发病的药物占比无统计学差异(P>0.05);23例CLD患者血清GGT和ALP分别为【430.7(156.00,1142.00)】U/L和(285.07±131.52)U/L,显著高于64例DILI患者的【111.5(18.00,185.60)】U/L和(140.28±101.36)U/L(P<0.05);两组血清ALT、GGT、ALP和TBIL复常时间差异无统计学意义(P>0.05)。结论慢性药物性胆汁淤积性肝病患者兼具肝脏炎症和胆汁淤积的临床表现,经积极治疗后近期预后好。
Objective To investigate the etiopathogenisis, clinical features and response to treatment of chronic drug-induced cholestatic liver disease. Methods A total of 87 patients with chronic drug-induced liver injury (DILI) hospitalized in our hospital from January 2011 to December 2013 were enrolled. Among them, 23 patients had cholestatic liver disease (CLD), chronic DILI without cholestasis 64 patients, the similarities and differences between the two groups of clinical data. Results Of the 23 patients with CLD, 11 were hepatocellular, 7 were cholestatic and 5 were mixed. Of 64 patients with DILI, 50 were hepatocellular, 4 were cholestatic and 10 were mixed. (P> 0.05). The serum GGT and ALP in 23 patients with CLD were 430.7 (156.00 and 1142.00), respectively, and there was no significant difference between the two groups U / L and (285.07 ± 131.52) U / L were significantly higher than those in 64 patients with DILI (111.5 ± 18.00,185.60 U / L and 140.28 ± 101.36 U / L, P <0.05) Serum ALT, GGT, ALP and TBIL no significant difference in the time of recovery (P> 0.05). Conclusions The patients with chronic drug-induced cholestatic liver disease have the clinical manifestations of liver inflammation and cholestasis. The short-term prognosis after active treatment is good.