实用肝脏病杂志 ›› 2026, Vol. 29 ›› Issue (2): 229-232.doi: 10.3969/j.issn.1672-5069.2026.02.017

• 药物性肝损伤 • 上一篇    下一篇

抗肿瘤药物致药物性肝损伤患者临床特征及其临床转归研究*

严鑫路, 张利华, 王韦韦, 武丽, 陈勇   

  1. 210000 南京市 南京医科大学附属明基医院药学部
  • 收稿日期:2025-11-07 出版日期:2026-03-10 发布日期:2026-03-13
  • 通讯作者: 陈勇,E-mail:donleechen@163.com
  • 作者简介:严鑫路,男,35岁,大学本科,主管药师。E-mail:yxl19901106@163.com
  • 基金资助:
    *南京医科大学科技发展基金资助项目(编号:NMUB20240139)

Clinical features and clinical outcomes of patients with anti-tumor drug-induced liver injury

Yan Xinlu, Zhang Lihua, Wang Weiwei, et al   

  1. Department of Pharmacy, BenQ Hospital Affiliated to Nanjing Medical University, Nanjing 210000, Jiangsu Province, China
  • Received:2025-11-07 Online:2026-03-10 Published:2026-03-13

摘要: 目的 探讨抗肿瘤药物所致药物性肝损伤(DILI)患者的临床特征及其转归。方法 2024年1月~2024年12月我院收治的抗肿瘤药物相关DILI患者197例,观察临床分型情况,并常规给予积极的护肝处理,总结临床特征,分析转归。结果 在197例DILI患者中,混合型26例,胆汁淤积型54例和肝细胞损伤型117例;肝细胞损伤型食欲减退占比为47.9%,显著高于胆汁淤积型的25.9%或混合型的25.0%(P<0.05);肝细胞损伤型血清GGT和ALP水平分别为(241.6±79.3)U/L和(99.7±22.8)U/L,均显著低于胆汁淤积型【分别为(835.2±274.8)U/L和(269.4±78.5)U/L,P<0.05】或混合型【分别为(439.7±145.1)U/L和(203.2±66.9)U/L,P<0.05】,而血清血清AST和ALT水平分别为(382.4±126.7)U/L和(601.9±183.5)U/L,均显著高于胆汁淤积型【分别为(124.9±41.3)U/L和(109.8±32.7)U/L,P<0.05】或混合型【分别为(140.5±46.2)U/L和(126.4±42.8)U/L,P<0.05】;肝细胞损伤型重度肝损伤占比为29.9%,显著低于胆汁淤积型的61.1%或混合型的53.9%(P<0.05);本组DILI患者治愈175例(88.8%),肝功能指标未恢复正常22例(11.2%),不同临床分型患者临床转归比较,差异无统计学意义(P>0.05)。结论 抗肿瘤药物容易导致DILI的发生,以肝细胞损伤型为主。注意监测,早期发现,积极护肝处理,大多数患者预后良好。

关键词: 药物性肝损伤, 抗肿瘤药物, 临床特征, 转归

Abstract: Objective This study aimed to summarize the clinical features and clinical outcomes of patients with anti-tumor drug-induced liver injury (DILI). Methods A total of 197 patients with anti-tumor DILI were encountered in this study between January and December 2024, and the clinical types were recorded. Clinical outcomes were observed after active liver protection treatment. Results Of the 197 patients with DILI, there were 26 cases of mixed type, 54 cases of cholestasis type and 117 cases of hepatocyte injury type; proportion of anorexia in hepatocyte injury type group was 47.9%, significantly higher than 25.9% in cholestasis type group or 25.0% in mixed type group (P<0.05); serum GGT and ALP levels in hepatocyte injury group were (241.6±79.3)U/L and (99.7±22.8)U/L, both much lower than [(835.2±274.8)U/L and (269.4±78.5)U/L, respectively, P<0.05] in cholestasis type group or [(439.7±145.1)U/L and (203.2±66.9)U/L, respectively, P<0.05] in mixed type group, while serum AST and ALT levels were (382.4±126.7)U/L and (601.9±183.5)U/L, both much higher than [(124.9±41.3)U/L and (109.8±32.7)U/L, respectively, P<0.05] in cholestasis type group or [(140.5±46.2)U/L and (126.4±42.8)U/L, respectively, P<0.05] in mixed type group; percentage of severe liver injury in patients with hepatocyte injury was 29.9%, much lower than 61.1% in patients with cholestasis type or 53.9% in those with mixed injury(P<0.05); liver function tests returned to normal in 175 cases (88.8%) and didn’t in 22 cases (11.2%), and there were no significant differences among liver function recovery rates in the three groups(P>0.05). Conclusion Anti-tumor immune, targeting and chemotherapy might induced DILI easily, and the hepatocyte injury type is very common. The prognosis is usually good with discontinuing anti-tumor medicines in time and active liver protecting treatment.

Key words: Drug-induced liver injury, Anti-tumor medicines, Clinical features, Outcome