老年与中青年药物性肝损害的临床比较

发布时间：2018-05-19 10:06

本文选题：药物性肝损害 + 年龄　；参考：《中国老年学杂志》2017年09期

【摘要】：目的探讨老年人药物性肝损害(DILI)的临床特点。方法选择84例DILI患者,按年龄分为老年组及中青年组,并进行对比分析。结果老年、中青年DILI患者占同期老年人、中青年肝病患者比例分别为4.77%、2.27%,二者差异显著(P0.05)。两组临床分型亦有差异。老年组黄疸和皮肤瘙痒发生率较高,与中青年组差异显著(P0.05)。老年组引起DILI的前5类药物为:中药(34.6%)、联合用药(15.4%)、抗微生物药(11.5%)、抗结核病药(11.5%)、激素类药(7.6%);中青年组依次为:中药(41.4%)、抗肿瘤药(12.1%)、抗微生物药(6.9%)、联合用药(6.9%)、抗甲状腺药(6.9%)。两组初始用药至发病的时间、住院天数、治疗前丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、碱性磷酸酶(ALP)值、临床转归及预后均无差异(P0.05)。结论 DILI在老年肝病患者中的占比高于中青年肝病患者。引起老年人肝损害的药物以中药、联合用药、抗微生物药、抗结核病药多见,临床表现以黄疸和皮肤瘙痒多见,一般预后较好。
[Abstract]:Objective to investigate the clinical features of drug-induced liver injury (DILI) in the elderly. Methods 84 patients with DILI were divided into two groups according to their age. Results in the elderly, the proportion of young and middle-aged patients with DILI was 4.772.27, and the proportion of young and middle-aged patients with liver disease was 4.770.The difference between them was significant (P 0.05). There were also differences in clinical classification between the two groups. The incidence of jaundice and pruritus in the aged group was higher than that in the middle and young group (P 0.05). The first five kinds of drugs caused by DILI in the elderly group were as follows: Chinese medicine 34. 6%, combined use 15. 4%, antimicrobial drug 11. 5%, antituberculosis drug 11. 5%, hormone drug 7. 6%; in the middle and young group, it was 41.4%, 12. 1%, 6. 9%, 6. 9%, 6. 9%, 6. 9%, 6. 9%, 6. 9% and 6. 9% respectively. There was no significant difference in the clinical outcome and prognosis between the two groups (P < 0.05), such as the time from the onset to the onset, the hospitalization days, the alanine aminotransferase (alt), the aspartate aminotransferase (AST), the total bilirubin (TBILL), the alkaline phosphatase (ALP), the clinical outcome and the prognosis of the two groups. Conclusion the proportion of DILI in elderly patients with liver disease is higher than that in young and middle-aged patients with liver disease. Traditional Chinese medicine, combined use, antimicrobial and anti-tuberculosis drugs are the most common drugs to cause liver damage in the elderly. Jaundice and skin pruritus are the most common clinical manifestations, and the general prognosis is good.
【作者单位】：南通卫生高等职业技术学校药学系;南通大学附属南通第三医院肝病科;
【基金】：江苏省卫生厅青年科研项目(No.Q201208) 江苏省高校“青蓝工程”资助(2016年)
【分类号】：R575

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