85例药物性肝病的临床病理分析

Clinical and pathological characteristics of 85 cases of drug induced liver disease

  • 摘要: 目的:分析药物性肝病(drug induced liver disease,DILD)的病因及临床和病理特点,以及早做出正确诊断与治疗。方法:根据服药史、临床表现、血清学指标、病理特点及停药后的治疗效果综合判断。结果:诱发DILD的药物主要是中草药(41.18%)、抗感染药(10.59%)、环境类毒物(10.59%)、解热镇痛药(8.24%)。慢性药物性肝病(chronic drug induced liver disease,CDILD)组血清总胆红素(TBIL)、直接胆红素(DBIL)高于急性药物性肝病(acute drug induced liver disease,ADILD)组,淤胆型的比例也高于ADILD。85例DILD的病理改变有一定的特征性,其中治愈50例,好转24例,无恶化或死亡病例。结论:DILD的常见诱发药物为中草药、抗感染药、环境类毒物、解热镇痛药,病理改变有一定的特征性,CDILD易出现淤胆型,预后良好。

     

    Abstract: Objective:To analyze pathogenesis,clinical and pathological characteristics of drug induced liver disease(DILD) for improving diagnosis and treatment.Methods: A total of 85 cases of patients with DILD admitted to our hospital from 2000 to 2005 were reviewed according to their drug histories,clinical features,pathological characteristics,liver function tests,and serum markers and responses to drug withdrawal.Results: The etiological drugs included Chinese herbal medicine(41.18%),anti-infectious drugs(10.59%),environment poison(10.59%),and analgesic-antipyretic drugs(8.24%).The levels of total bilirubin and direct bilirubin in drug induced chronic liver disease and cholestatic liver disease patients were higher than that in acute drug induced liver disease.Pathological characteristics of DILD was different from other liver diseases.There were 50 cases cured,24 cases improved,0 deteriorated or died.Conclusion: Chinese herbal medicine,anti-infectious medicine,environment poison and analgesic-antipyretic medicine are common etiological agents of DILD.Pathological characteristics of DILD is different from other liver diseases.The proportion of cholestatic type is more in chronic DILD.Most patients have good prognoses.

     

/

返回文章
返回