75例中药诱导的肝损伤患者临床特征分析*

doi:10.3969/j.issn.1672-5069.2019.05.014

实用肝脏病杂志 ›› 2019, Vol. 22 ›› Issue (5): 668-671.doi: 10.3969/j.issn.1672-5069.2019.05.014

75例中药诱导的肝损伤患者临床特征分析*

吴欣, 郭杨志, 杜霄壤, 吴孟晋, 朱云, 冯兴中

100038 北京市首都医科大学附属北京世纪坛医院中医科（吴欣,郭杨志,杜霄壤,吴孟晋,冯兴中）; 解放军总医院第五医学中心中西医结合肝病中心（朱云）

收稿日期:2018-10-10 出版日期:2019-09-10 发布日期:2019-09-16
通讯作者: 冯兴中,E-mail:fengxz9797@sina.com
作者简介:吴欣,男,47岁,副主任医师。主要从事中西医结合治疗肝病研究。E-mail：jhwux2@163.com
基金资助:
首都医科大学基础和临床科研基金与李桓英联合基金资助项目（编号:17JL-L04）

Clinical features of herb-induced liver injury

Wu Xin, Guo Yangzhi, Du Xiaorang, et al

Department of Traditional Chinese Medicine,Shijitan Hospital Affiliated to Capital Medical University,Beijing 100038,China

Received:2018-10-10 Online:2019-09-10 Published:2019-09-16
Contact: Feng Xinzhong,E-mail:fengxz9797@sina.com

摘要/Abstract

摘要： 目的观察和总结中药诱导的肝损伤（HILI）患者的临床特征。方法 2015年1月~2015年12月期间我院收治的75例HILI患者,经RUCAM评分大于3分诊断。结果本组肝细胞损伤型59例,胆汁淤积型11例,混合型5例;63例（84.0%）为急性起病,能提供中药组分的39例患者中何首乌导致的HILI为17例（22.7%）;混合型中瘙痒3例（60.0%）,显著高于肝细胞损伤型6例（10.2%）和胆汁淤积型4例（36.4%,P=0.00）;肝细胞损伤型谷丙转氨酶为（623.4±450.2） U/L,显著高于混合型的（84.4±57.4） U/L或胆汁淤积型的（179.5±75.5） U/L （P<0.05）;肝细胞损伤型、混合型和胆汁淤积型总胆红素分别为（148.0±127.0） μmol/L、（150.8±102.6） μmol/L和（128.8±76.2） μmol/L（P>0.05）。结论何首乌为引起HILI的主要致病中药,以肝细胞损伤型占多数,且多为急性起病。HILI患者在停药后,大多预后良好。

关键词: 药物性肝损伤, 中药, 临床特征

Abstract: Objective To summarize the clinical features of herb-induced liver injury （HILI）. Methods Seventy-five patients with HILI were diagnosed by Uclaf causality assessment method（RUCAM） scores greater than 3 between January 2015 and December 2015. Results There were 59 patients with hepatocellular,11 with cholestatic and 5 with mixed injuries in this series;among the 75 cases,63 （84.0%） were acute HILI;in 39 patients with definite Chinese medicine ingredients,17 cases（43.6%） were caused by polygonum multiflorum;3 cases （60.0%） in mixed liver injuries had pruritus,significantly higher than 6 cases （10.2%） in patients with hepatocellular or 4 cases （36.4%） in cholestasitic liver injuries （P=0.00）;serum alanine aminotransferase level in patients with hepatocellular liver injury was （623.4±450.2） U/L,significantly higher than （84.4±57.4） U/L in patients with mixed or（179.5±75.5） U/L in those with cholestasis liver injury（P<0.05）;total serum bilirubin level in patients with hepatocellular,mixed and cholestasitic damages were（148.0±127.0） μmol/L,（150.8±102.6） μmol/L and（128.8±76.2） μmol/L,respectively（P>0.05）. Conclusion s Polygonum multiflorum is the most common cause of HILI,hepatocellular damage is more common in patients with HILI,and most cases presents as acute onset. The prognosis of patients with HILI is good.

Key words: Herb-induced liver injury, Traditional Chinese medicines, Clinical features

吴欣, 郭杨志, 杜霄壤, 吴孟晋, 朱云, 冯兴中. 75例中药诱导的肝损伤患者临床特征分析*[J]. 实用肝脏病杂志, 2019, 22(5): 668-671.

Wu Xin, Guo Yangzhi, Du Xiaorang, et al. Clinical features of herb-induced liver injury[J]. Journal of Practical Hepatology, 2019, 22(5): 668-671.

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75例中药诱导的肝损伤患者临床特征分析*

Clinical features of herb-induced liver injury

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