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目的分析药物性肝损伤的临床特点及涉及药物。方法选取桂林市中西医结合医院2013年1月—2014年9月收治的168例药物性肝损伤患者,其中肝细胞型135例(A组),胆汁淤积型14例(B)组回,混合型19例(C组),顾性分析其临床资料。结果 3组患者性别、年龄、谷氨酸氨基转移酶(ALT)峰值比较,差异无统计学意义(P>0.05),住院时间、血清总胆红素(TBi L)峰值、碱性磷酸酶(ALP)峰值、谷氨酰转移酶(GGT)峰值、国际标准化比值(INR)比较,差异有统计学意义(P<0.05)。3组患者使用的首位药物为抗结核药,其次为中成药,再次为抗生素,分别占36.3%(61/168)、17.9%(30/168)、7.7%(13/168)。3组患者的治愈率、好转率、无效率、病死率比较,差异无统计学意义(P>0.05)。结论药物性肝损伤的临床表现无特异性,临床医师在用药过程中应充分重视患者肝功能的检测。
Objective To analyze the clinical features of drug-induced liver injury and its related drugs. Methods A total of 168 patients with drug-induced liver injury were enrolled from January 2013 to September 2014 in Guilin Integrative Medicine Hospital, including 135 hepatocellular (A) and 14 cholestatic (B) patients. Type 19 cases (C group), to analyze the clinical data. Results There were no significant differences in the gender, age, and ALT peak value between the three groups (P> 0.05), length of hospital stay, peak of serum total bilirubin (TBiL), alkaline phosphatase ALP peak, glutamyl transferase (GGT) peak, the international standardization ratio (INR), the difference was statistically significant (P <0.05). The first drug used in the three groups was anti-TB drugs, followed by proprietary Chinese medicines and antibiotics again, accounting for 36.3% (61/168), 17.9% (30/168) and 7.7% (13/168) respectively. There was no significant difference in the cure rate, improvement rate, inefficiency rate and mortality between the three groups (P> 0.05). Conclusion The clinical manifestations of drug-induced liver injury are nonspecific. Clinicians should pay full attention to the detection of liver function in the course of medication.