作　　者： (贾王平）; (郭代红）; (田小燕）; (寇炜）; (王啸宇）; (赵粟裕）; (胡鹏洲）;

机构地区： 解放军总医院药学部临床药学中心,北京100853

出　　处： 《中国药物警戒》 2017年第8期481-485,共5页

摘　　要： 目的了解各类药物导致药物性肝损害(DILI)发生的情况和特点,为防治DILI提供参考。方法采用回顾性分析的方法,从解放军药品不良反应监测中心数据库中提取并筛选2008~2016年严重不良反应报告中发生DILI的病例,对患者的性别及年龄、引起DILI的药品、实验室指标与主要临床表现、发生DILI的时间及给药途径、DILI转归及治疗等进行统计分析。结果在1 110例DILI中,男女比例为1.51:1;男女患者年龄构成比差异具有统计学意义(χ~2=11.330,P=0.01);引起DILI前3大类药物依次为抗感染药物、神经系统用药、心血管系统用药;引起DILI频次较高的药物为阿托伐他汀、利福平、莫西沙星、左氧氟沙星等;在DILI的转归中,应用保肝药物的患者治愈和好转的构成比更高(χ~2=25.136,P<0.001)。结论临床医务人员应加深对导致DILI药物的认识,合理用药;而对于DILI的患者,应及时停药,并积极对症治疗。 Objective To investigate the condition and characteristics of drug-induced liver injury（DILl）, and provide reliable basis for theprevention and treatment of DILl. Methods The cases of DLLI were collected from database of PLA ADIL Monitoring Center from 2008 to 2016 and then patients＇ information, suspicious drugs, laboratory indexes and major manifestations, occurring time of DILl and administration route, treatment and outcomes were analyzed retrospectively. Results Among 1 110 DILI cases, the ratio of males and females was 1.51：1. Significant differences of age existed between males and females （χ^2=-25.136, P=0.01）. The three predominant drug classifications were anti-infective agents, nervous system drugs, cardiovascular system drugs orderly. The predominant drugs were atorvastatin, rifampicin, moxifloxacin and levofloxacin orderly. Significant difference of outcomes existed between patients taking liver-protecting drugs and patients not taking liver-protecting drugs （χ^2=25.136,P〈0.001）.Gonclusion Clinical medical stafl~ should learn more about drugs and use them reasonably, drug withdrawal and other symptomatic treatments should be given in time for patients with DILI.

关 键 词： 药物性肝损害 药品不良反应 合理用药