药物性肝病临床探讨

目的探讨31例药物性肝病患者的病因和临床特点，以提高临床医师对该病的认识和掌握。方法采用回顾性分析对31例药物性肝病住院患者的用药史、临床表现、肝功能检查、病原学标志以及治疗转归作出综合判断，部分患者结合肝活检组织学检查可使诊断更为明确。结果引起肝病的相关药物中．抗菌素类药占22．6％(7／31)，中药占19．3(6／31)，抗结核类药占12．9％(4／31)，抗肿瘤类药占9．6％(3／31)，解热镇痛类药9．6％(3／31)，抗甲状腺类药6．4％(2／31)、其他药物占6．4％(2／31)，另有4例(12．9％)用药不详。临床分型：急性药物性肝病26例，慢性药物性肝病5例。临床表现根据药物不同作用机制而有所不同，住院患者主要表现为黄疸和转氨酶升高。经停药并给予保肝解毒治疗，30例预后良好，有1例用抗结核药物患者致肝硬化。结论临床医师应重视药物性肝病的预防、诊断和治疗。

Clinical implications of drug-induced liver disease

Ojective The aim of the present study was to examine the etiology and clinical manifestation of patients with drug-induced liver disease. Methods Thirtyone patients with drug-induced liver disease were examined of drug history, clinical symptom and signs,laboratory tests and therapeutic effect, In some cases, hepatic biopsy was carried out to help diagnose.Results It was suggested that the proportion of drugs which induced liver disease were antibiotics 22.6%, anti-tuberculosis 12.9%. There were 26 patients with acute and 5 patients with chronic drug-induced liver disease. The dominating clinical manifestation were jaundice and elevated transaminase.The most patients were cured with good prognosis. Conclusion The clinicians should attach importance to the prevention, diagnosis and therapy of drug-induced liver disease.