低分子肝素治疗肺血栓栓塞症引起急性药物性肝损伤的临床特征及预后因素分析

发布时间：2018-05-04 09:37

  本文选题：低分子肝素 + 药物性肝损伤　； 参考：《中国临床药理学杂志》2017年17期

【摘要】：目的探讨低分子肝素(LMWH)引起急性药物性肝损伤(DILI)的临床特征及预后因素。方法根据国际公认的Roussel Uclaf因果关系评估方法(RUCAM)2015版,收集我院使用低分子肝素治疗肺血栓栓塞症(PTE)引起急性DILI的住院患者基本信息、医嘱、实验室检查结果等资料。结果共纳入患者92例,其中82.61%的DILI患者经RUCAM评分判断为"非常可能"和"很可能"(≥6分)。DILI分型诊断中肝细胞型18例(19.57%),混合型45例(48.91%),胆汁淤积型29例(31.52%)。基本资料统计显示,3组间谷丙转氨酶、谷草转氨酶、碱性磷酸酶和总胆红素水平差异有统计学意义(P0.05)。多因素回归显示,伴重症感染(P0.05)是低分子肝素引起混合型DILI的不良预后因素,高血肌酸酐(Scr)水平(P0.05)是低分子肝素引起肝细胞型DILI的不良预后因素。用药后发生DILI时间、实验室指标异常达峰时间、转归时间和结局在3种DILI类型间差异无统计学意义(P0.05)。结论当使用低分子肝素治疗PTE患者同时伴随重症感染和/或高Scr水平时,应加强对DILI的监护与判断,必要时根据DILI分型对症处理。
[Abstract]:Objective to investigate the clinical features and prognostic factors of acute drug-induced liver injury induced by low molecular weight heparin (LMWHs). Methods according to the internationally accepted Roussel Uclaf causality assessment method, Rucam 2015, we collected the basic information, medical advice and laboratory results of patients with acute DILI who were treated with low molecular weight heparin (LMWH). Results 92 patients were included, of whom 82.61% of DILI patients were diagnosed as "very likely" and "very likely" by RUCAM score (鈮，

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