80例药物性肝损伤患者临床特征与预后分析*

doi:10.3969/j.issn.1672-5069.2025.01.019

实用肝脏病杂志 ›› 2025, Vol. 28 ›› Issue (1): 72-75.doi: 10.3969/j.issn.1672-5069.2025.01.019

80例药物性肝损伤患者临床特征与预后分析^*

莫伟斌, 欧阳婉爱, 黄晓涵, 何鼎醇

510000 广州市广州医科大学附属第八医院肝病科(莫伟斌);门诊部(欧阳婉爱);附属第一人民医院感染病科(黄晓晗);广东省佛山市南海区人民医院感染病中心(何鼎醇)

收稿日期:2024-05-11 出版日期:2025-01-10 发布日期:2025-02-07
通讯作者: 何鼎醇,E-mail:962039648@qq.com
作者简介:莫伟斌,男,48岁,大学本科,副主任医师。E-mail:lightning-benny@163.com
基金资助:
^*广东省自然科学基金资助项目(编号:2024A1515011874)

Clinical feature and outcomes of patients with drug-induced liver injury: An analysis of 80 cases

Mo Weibin, Ouyang Wanai, Huang Xiaohan, et al

Department of Liver Disease, Eighth Hospital Affiliated to Guangzhou Medical University, Guangzhou 510000, Guangdong Province, China

Received:2024-05-11 Online:2025-01-10 Published:2025-02-07

摘要/Abstract

摘要： 目的分析一组药物性肝损伤(DILI)患者临床特征及预后转归情况。方法 2021年1月～2023年12月我院收治的80例DILI患者,常规进行临床分型、停止可疑药物和积极的护肝处理1～3周,总结临床特征,并分析预后情况。结果在80例DILI患者中,肝细胞型41例(51.3%),胆汁淤积型14例(17.5%)和混合型25例(31.2%);肝细胞型患者消化系统症状占比为51.2%,显著高于胆汁淤积型的21.4%或混合型的24.0%,丙氨酸氨基转移酶(ALT)水平为(646.2±177.5)U/L,显著高于胆汁淤积型【(91.4±28.9)U/L,P<0.05】或混合型【(140.8±42.4)U/L,P<0.05】,天冬氨酸氨基转移酶(AST)水平为(430.7±123.9)U/L,显著高于胆汁淤积型【(111.4±42.6)U/L,P<0.05】或混合型【(129.1±60.7)U/L,P<0.05】,碱性磷酸酶(ALP)水平为(90.6±19.4)U/L,显著低于胆汁淤积型【(258.1±83.3)U/L,P<0.05】或混合型【(191.4±50.8)U/L,P<0.05】,谷氨酰转肽酶(GGT)水平为(263.9±100.7)U/L,显著低于胆汁淤积型【(881.4±350.2)U/L,P<0.05】或混合型【(475.1±192.3)U/L,P<0.05】;本组DILI患者痊愈69例(86.3%),未痊愈11例(13.7%),不同型患者预后差异无统计学意义(P>0.05)。结论 DILI患者最常见的临床分型为肝细胞型,更容易出现消化系统症状。大部分DILI患者预后较好,但中药引起的肝损伤仍不容忽视。

关键词: 药物性肝损伤, 临床特征, 转归

Abstract: Objective The aim of this study was to summarize clinical feature and outcomes of 80 patients with drug-induced liver injury (DILI). Methods The clinical data of 80 patients with DILI were retrospectively analyzed in our hospital between January 2021 and December 2023, the alleged medicines were discontinued and liver-protecting agents were given for one to three weeks. The outcomes was recorded. Results As for clinical catalogue in 80 patients with DILI, hepatocellular type was found in 41 cases (51.3%), cholestatic type in 14 cases (17.5%) and mixed type in 25 cases (31.2%); gastrointestinal symptoms was found in 51.2% of patients with hepatocellular type, much higher than 21.4% of patients with cholestatic type or 24.0% of those with mixed type; serum ALT level in patients with hepatocellular type was (646.2±177.5) U/L, much higher than [(91.4±28.9)U/L, P<0.05] in with cholestatic type or [(140.8±42.4)U/L, P<0.05] in with mixed type, AST level was 430.7±123.9)U/L, much higher than [(111.4±42.6)U/L, P<0.05] in cholestatic type or [(129.1±60.7)U/L, P<0.05] in mixed type, ALP level was (90.6±19.4)U/L, much lower than [(258.1±83.3)U/L, P<0.05] in with cholestatic type or [(191.4±50.8)U/L, P<0.05] in mixed type, and GGT level was (263.9±100.7)U/L, much lower than [(881.4±350.2)U/L, P<0.05] in with cholestatic type or [(475.1±192.3)U/L, P<0.05] in mixed type; 69 patients (86.3%) in our series recovered and 11 patients (13.7%) didn’t, without significant differences among patients with different clinical catalogue (P>0.05). Conclusion The most common clinicaltype of patients with DILI is hepatocellular, with digestive symptoms more common. Most DILI patients have good prognosis, while liver injury caused by herbal medicines cannot be ignored.

Key words: Drug-induced liver injury, Clinical feature, Prognosis

莫伟斌, 欧阳婉爱, 黄晓涵, 何鼎醇. 80例药物性肝损伤患者临床特征与预后分析^*[J]. 实用肝脏病杂志, 2025, 28(1): 72-75.

Mo Weibin, Ouyang Wanai, Huang Xiaohan, et al. Clinical feature and outcomes of patients with drug-induced liver injury: An analysis of 80 cases[J]. Journal of Practical Hepatology, 2025, 28(1): 72-75.

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80例药物性肝损伤患者临床特征与预后分析^*

Clinical feature and outcomes of patients with drug-induced liver injury: An analysis of 80 cases

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