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目的探讨药物性肝损害的病因、临床特点、过敏原检测、分型、治疗效果及预后分析。方法选择四川省人民医院370例临床诊断为药物性肝损害的门诊及住院患者,对其用药史、临床表现、肝功能、过敏原检测及预后等进行回顾性分析。结果引起药物性肝病的前3位药物分别为中草药(27.30%)、抗肿瘤药物(18.92%)、抗结核药物(13.78%);临床表现非特异。肝损害以肝细胞损害型最为常见(56.76%)。过敏原IgE检测阳性率高达68.11%,高IgE提示过敏的可能性大。药物性肝损害患者的预后较好,其中治愈和好转率达85.95%。结论引起药物性肝病的药物种类繁多,由于药物性肝病临床表现无特异性,易误诊及漏诊,因此在临床工作中应重视药物性肝损害,过敏原检测有一定临床意义。
Objective To investigate the etiology, clinical features, allergen detection, typing, therapeutic effect and prognosis of drug-induced liver damage. Methods 370 outpatients and inpatients diagnosed as drug-induced liver injury in Sichuan Provincial People’s Hospital were selected for retrospective analysis of their medication history, clinical manifestations, liver function, allergen detection and prognosis. Results The first three drugs causing drug-induced liver disease were Chinese herbal medicine (27.30%), antineoplastic drugs (18.92%) and anti-tuberculosis drugs (13.78%). The clinical manifestations were nonspecific. Liver damage is the most common type of hepatocellular damage (56.76%). Allergen IgE test positive rate as high as 68.11%, high IgE prompted the possibility of allergies. The prognosis of patients with drug-induced liver damage is good, of which cure and improvement rate of 85.95%. Conclusions A wide variety of drugs cause drug-induced liver disease. Due to the non-specific clinical manifestations of drug-induced liver disease, misdiagnosis and missed diagnosis, drug-induced liver damage should be emphasized in clinical work. Allergen testing has clinical significance.