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1、药物性肝损害130例的临床研究【关键词】药物性【摘要】目的总结药物性肝损害的临床特点，为诊断和治疗积累经验，避免漏诊和误诊。方法冋顾性分析1997〜2002年北京地坛医院收治的130例药物性肝损害患者的临床资料。结果(1)130例患者中，中老年占70例(61.5%),青少年占60例(38.5%),男51例(39.2%),女79例(60.8%)o肝损害发生于用药后1周内的4例(3.1%),1〜4周内的43例(33.1%),超过4周的75例(57.7%),未记录者8例。(2)中药所致川:损害73例(56.2
2、%),西药所致肝损害57例(43.8%)o2次用同一药物发病的有19例，3次用药发病的有4例，4次用一药发病的有1例。原发病中较常见的有:皮肤病39例(30%)、纟核病19例(14.6%),彳谢性疾病15例(11.5%).骨关节疾病10例(7.7%)o(3)130例患者的临床症状、体征及生化检杏与病毒性肝炎相似，68例曾被误诊为病毒性肝炎，经过常规保肝笏物治疗病情痊愈者63例，好转者58例，未愈者3例，死亡6例。结论(1)本文中治疗皮肤病的药物引起肝损害的最多。(2)临床医师在治疗皮肤病、结核病时应注意
3、监测肝功。(3)本组病例的肝损害多发生于用药4周后，可能与木病起病隐匿、发现较晚有关，但也提示既往经典诊断标准可能有不完善之处。【关键词】药物性肝损害;临床研究Theclinicalstudyof130casesofdrug-inducedliverdiseaseDUANXue-fei,GUOJia-zhen,LIUZhuang.BeijingDitanHospital,Beijing100011,China【Abstract]ObjectiveTosummarizetheclinicalcharact
4、eristicsofdrug-inducedliverinjuryinordertoaccumu-latetheexperienceofdiagnosisandtreatment,avoidmisdiagnosisandmisseddiagnosis.MethodsClinicaldataofl30patientssufferedfromdrug-inducedinjuryfrom1997to2002werereviewed.Results(1)Amongthel30pa-tientST51aremal
5、e(39.2%),79arefemale(57.7%),70patientsareover40yearsold(61.5%),60patientsarecallan(38.5%).4cases(3.1%)appearedliverinjuryinthefirstweekofthemedication,43casesappearedinlhel〜4weeks(33.1%),75casesappearedover4weeks(57.7%),and8caseswerenotrecorded・(2)73case
6、swereinjuriedbyChinesetraditionalmedicine(56.2%),and57casesbywesternmedicine(43.8%).Therearel9pa-tientsinjuriedbyusingthesamedrugtwice,4patientsinjuriedbyusingthesamedrugthrice,and1patientinjuriedbyusingthesamedrugfourtimes.Theusualunderlyingdiseasesincl
7、ude:39casesofdermatologicdisease(30%),19casesoftuberculosis(14.6%),15casesofmetabolicdisease(11.5%),1Ocasesofbone-jointdisease(7.7%).(3)Clinicalsigns,symptomsandbiochemicalexaminationofallthel30patientsareverysimiliarwithviralhepatitis,68casesaremisdiagn
8、osed.Aftertreatment63patientsrecovered,58patientstookaturnforthebetter,3patientsun-recovered,6patientsdied.Conclusion(1)Themostcommonreasonwhichcauseliverinjuryisthedermatologicdiseasedruginthisstudy.(2)Whenwetreatthederma
