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目的探讨环丙沙星致肝损害的规律与特点,为临床医生合理用药提供参考。方法检索国内外有关医药数据库,下载病例报告原文进行统计与分析。结果环丙沙星致肝损害病例报告32例,其中男性22例,40岁以上的中老年人23例。肝损害的主要临床表现为黄疸、恶心、腹痛、转氨酶升高,以肝细胞型为主,胆汁淤积型次之,混合型少见。中老年、男性、药物过敏史、原患肝病、合并肝毒性药物、再次用药、剂量过大、疗程过长等属高危人群和危险因素。经停药、采取相应治疗措施,大部分可恢复正常,但也可进展为慢性化、肝衰竭,严重者死亡。已有至少3例死亡报告。结论环丙沙星的肝损害严重不良反应应引起临床医务人员的高度重视。
Objective To investigate the rules and characteristics of ciprofloxacin-induced liver damage and provide reference for the rational use of drugs by clinicians. Methods Retrieve the relevant medical databases at home and abroad, download the case reports for statistical analysis. Results Ciprofloxacin caused liver damage in 32 cases, including 22 males and 23 aged 40 and over. The main clinical manifestations of liver damage is jaundice, nausea, abdominal pain, elevated transaminases, mainly hepatocellular type, followed by cholestasis, mixed rare. Middle-aged and elderly men, history of drug allergy, former liver disease, hepatotoxicity, re-medication, overdose, long course of treatment and other high-risk groups and risk factors. After the withdrawal, to take the appropriate treatment, most can return to normal, but also can progress to chronic, liver failure, severe death. At least 3 deaths have been reported. Conclusion Serious adverse reactions of ciprofloxacin in liver damage should be paid great attention to by clinicians.