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目的探讨DILD的临床特点及预防措施。方法回顾性地分析90例DILD住院患者的临床资料。结果90例DILD患者中男性38例,女性52例;年龄(56.9±11.7)岁;诱发DILD的药物涉及临床各科应用58个品种,均为常规剂量,用药平均(3.7±2.1)种;西药所致DILD57例(63.3%)、中药28例(31.1%)、保健品5例(5.5%)。无肝病临床表现,复查肝功能发现DILD18例;肝细胞型损伤70例,淤胆型肝损伤16例,混合型肝损伤4例。DILD出现时间在药物应用的3-76d,平均(36.9±11.8)d。治愈好转87例,自动出院2例,死亡1例。结论DILD临床比较常见,引起DILD的药物品种较多,应严格把握用药指征,尤其要警惕中草药的肝毒性,注意个体化;尽量减少多药并用;加强用药过程中的监护,定期检查肝功能。
Objective To investigate the clinical features and preventive measures of DILD. Methods A retrospective analysis of 90 cases of DILD hospitalized patients clinical data. Results Among 90 DILD patients, 38 were male and 52 were female, with a mean age of (56.9 ± 11.7) years. DILD-induced drugs involved 58 clinical varieties, which were all routine doses (average, 3.7 ± 2.1) As a result, 57 cases (63.3%) had DILD, 28 cases (31.1%) had TCM and 5 cases (5.5%) had health care products. No clinical manifestations of liver disease, review of liver function found DILD18 cases; liver cell injury in 70 cases, cholestatic liver injury in 16 cases, 4 cases of mixed liver injury. DILD appeared in the drug application 3-76d, the average (36.9 ± 11.8) d. 87 cases were cured, 2 cases were discharged automatically and 1 case died. Conclusion DILD is more common in clinical practice. DILD is more likely to cause drug abuse. Strict indications should be given to medication use. In particular, we should guard against hepatotoxicity of Chinese herbal medicine and pay attention to individualization. Minimal use of multidrugs should be minimized. Intensive care should be exercised to check liver function regularly .