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目的探讨药物性肝病的致病因素及预防方法。方法选取2010年1月至2014年1月我院所收治的73例药物性肝病患者,基于Zakim分类标准、药物性肝病诊断标准、影像学检查、服药史、实验室检查、临床症状进行判定。结果本组患者出现乏力(53.4%)、恶心及食欲减退(61.6%)、发热及皮疹(6.8%)、瘙痒(11.0%)、黄疸(35.6%)、腹痛(15%)。11例(15%)患者嗜酸性粒细胞大于6%,65例(89.0%)患者胆红素异常,68例(93.2%)患者天冬氨酸氨基转移酶(AST)升高,70例(95.9%)患者谷丙转氨酶(ALT)升高。结论预防对于药物性肝病的防治而言极为重要,应尽量少用对肝脏有毒性的药物,不能长期大量用药,应慎重考虑药物的使用剂量,广泛开展个体化用药。在患者用药期间,要对患者的尿常规、血常规、肝功能进行动态监测,尽早发现、尽早治疗。
Objective To explore the causative factors and preventive methods of drug-induced liver disease. Methods 73 patients with drug-induced liver disease admitted from January 2010 to January 2014 in our hospital were selected based on Zakim classification criteria, diagnostic criteria of drug-induced liver disease, imaging examination, medication history, laboratory tests and clinical symptoms. Results The patients presented with fatigue (53.4%), nausea and loss of appetite (61.6%), fever and rash (6.8%), pruritus (11.0%), jaundice (35.6%) and abdominal pain (15%). Eleven patients (15%) had eosinophils greater than 6% and 65 patients (89.0%) had abnormal bilirubin, 68 patients (93.2%) had elevated AST, 70 95.9%) patients with elevated alanine aminotransferase (ALT). Conclusion Prevention is very important for the prevention and treatment of drug-induced liver disease. Drugs that are toxic to the liver should be used as little as possible and drugs should not be used in large quantities for a long time. Careful consideration should be given to the dosage of drugs used and individualized medication should be widely used. During the patient medication, to the patient’s urine routine, blood, liver function dynamic monitoring, early detection, early treatment.