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目的:探讨药物性肝损害的病因及临床特点,以帮助临床医师对该病做出正确的诊断和治疗。方法:对138例急性药物性肝损害患者的服药史、临床症状、肝功能试验、停药后的反应等进行分析。结果:引起肝损害的药物中,中药类占39.13％、抗结核14.49％、抗生素占9.42％、皮肤科用药占7.97％、免疫抑制剂占12.31％、解热止痛剂占3.62％、神经系统占4.35％、消化系统占2.90％、化疗药占2.90％、内分泌和代谢药占2.17％、其他占0.72％。临床类型中肝细胞损伤型占36.2％、胆汁淤滞型占40.5％、混合型占23.3％。 结论:抗菌素引起的肝损害减少,中药引起的增加,其临床表现与病毒性肝炎相似。
Objective: To explore the etiology and clinical features of drug-induced liver damage to help clinicians make correct diagnosis and treatment of the disease. Methods: 138 cases of acute drug-induced liver damage in patients with medication history, clinical symptoms, liver function tests, after stopping the reaction were analyzed. Results: Among the drugs that cause liver damage, 39.13% were traditional Chinese medicines, 14.49% were anti-TB drugs, 9.42% were antibiotics, 7.97% were dermatological drugs, 12.31% were immunosuppressants, 3.62% were antipyretic and analgesic drugs, nervous system accounted for 4.35%, digestive system accounted for 2.90%, chemotherapeutic drugs accounted for 2.90%, endocrine and metabolic drugs accounted for 2.17%, others accounted for 0.72%. Clinical types of hepatocellular injury accounted for 36.2%, 40.5% of cholestasis, mixed accounted for 23.3%. Conclusions: The antibiotic-induced liver damage is reduced and the Chinese medicine is caused to increase. Its clinical manifestations are similar to those of viral hepatitis.