128例药物性肝病分析(1)
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[摘要] 目的 对药物性肝病的临床特点进行分析。 方法 回顾性分析128例药物性肝病患者的临床资料。 结果 导致药物性肝病的药物种类繁多，其中中草药及中成药(25.00%)、抗结核药(20.31%)所占比例最多；肝细胞型患者75例，胆汁淤滞型36例，混合型17例；128例患者发病时间，<1周患者5例，1~5周患者11例，6~12周患者46例，13~19周患者35例，20~26周患者7例，27~33周患者15例，>33周患者9例；115例患者预后良好，其余13例预后欠佳，其中12例发生重型肝炎，1例死亡。 结论 中草药及中成药和抗结核药是引起药物性肝病的主要药物，应定期检测肝功能。
[关键词] 药物性肝病；临床特点；分析；中药
[中图分类号] R575 [文献标识码] A [文章编号] 1674-4721(2012)02(a)-0021-02
Clinical analysis of 128 cases with drug-induced liver disease
HU Zhiming
Department of Gastroenterology, People's Hospital of Taojiang County in Hunan Province, Taojiang 413400, China
[Abstract] Objective To study the clinical features of drug-induced liver disease. Methods The clinical data of 128 cases with drug-induced liver disease were retrospectively analyzed. Results There were various drugs which could result in drug-induced liver disease, with the traditional Chinese medicines (25.00%) and anti-tuberculosis drugs (20.31%) taking the maximum of proportion. There were 75 cases with liver cell type, 36 cases with bile stasis type, and 17 cases with the mixed type. As to the onset time, there were 5 cases (< 1 week), 11 cases (1-5 week), 46 cases (6-12 week), 35 cases(13-19 week), 7 cases (20-26 week), 15 cases (27-33 week) and 9 cases (> 33 week). 115 cases had good prognosis, while the other 13 cases had bad prognosis including 12 patients with severe hepatitis and one death. Conclusion Traditional Chinese medicines and anti-tuberculosis drugs are the main kinds of drugs, which can cause drug-induced liver disease, and the liver function of patients taking these drugs should be regularly detected.
[Key words] Drug-induced liver disease; Clinical features; Analysis; Traditional Chinese medicine
药物性肝病(Drug-induced liver disease)在临床上表现症状多样，可表现为发热、皮疹、黄疸以及转氨酶升高等，部分患者甚至会出现急性肝功能衰竭等较为严重的并发症；在西方国家,由药物引起的急性肝功能衰竭占全部肝功能衰竭患者的10%～52%。有文献报道显示，药物性肝病占所有药物损害病例的10%～15%[1]。由于药物性肝病临床表现较为复杂，实验室检查又缺乏特异性，因此常常易导致漏诊、误治。现对本院2002年1月～2010年12月收治入院的128例药物性肝病患者的临床资料进行分析，报道如下：
1资料与方法
1.1一般资料
本组患者128例，均为本院于2002年1月～2010年12月收治的患者，所有患者均符合药物性肝病诊断标准[2] ......
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