抗感染药致药源性肝损伤572例分析

发布时间：2018-11-19 15:39

【摘要】：目的:了解抗感染药相关的药源性肝损伤(DILI)发生的情况及特点,为防治抗感染药相关的DILI提供参考。方法:采用回顾性分析方法,调取2009-2013年解放军药品不良反应(ADR)监测中心数据库中抗感染药致DILI报告572例,对涉及患者的年龄、性别、主要诊断等基本信息,引发DILI的药物类别与品种、剂型、给药途径、发生时间、实验室指标、DILI分型及临床表现,保肝药物的应用以及转归等情况进行描述性统计、分析。结果:572例DILI中,男性患者412例(72.03%),女性患者160例(27.97%),平均年龄(44.54±23.75)岁;涉及抗感染药六大类57个品种,引发ADR频次较高的药物为利福平、异烟肼、莫西沙星、氟康唑、阿奇霉素、头孢呋辛、头孢哌酮/舒巴坦、左氧氟沙星、头孢西丁和伏立康唑等;静脉滴注是引发ADR的主要给药途径,占74.48%。ADR的发生时间相对集中,多在用药后2周以内(86.19%)。对可进行肝损伤分型的360例ADR评价,以肝细胞损伤型为主,占93.33%。大部分病例在停药和对症治疗后治愈和好转(82.17%)。结论:头孢菌素类、氟喹诺酮类、抗结核药以及抗真菌药物可能是引发抗感染药致DILI的主要药物,临床分型以肝细胞损伤型最为常见,患者大多预后良好。临床医务人员应该提高对抗感染药致DILI的认识,并加强防范。
[Abstract]:Objective: to investigate the occurrence and characteristics of (DILI) in drug-induced liver injury associated with anti-infective agents, and to provide reference for the prevention and treatment of anti-infective DILI. Methods: using retrospective analysis, 572 cases of DILI were reported in the database of (ADR) Monitoring Center for adverse Drug reactions of PLA from 2009 to 2013. The basic information including age, sex, main diagnosis and so on were collected. The types and types of drugs, dosage form, route of administration, time of occurrence, laboratory indexes, DILI classification and clinical manifestations, application and outcome of hepatoprotective drugs were analyzed and analyzed. Results: in 572 cases of DILI, 412 cases (72.03%) were male and 160 cases (27.97%) were female. The average age was (44.54 卤23.75) years. Involving 57 varieties of antiinfective drugs, the drugs with high ADR frequency were rifampicin, isoniazid, moxifloxacin, fluconazole, azithromycin, cefuroxime, cefoperazone / sulbactam, levofloxacin, Cefoxitin and voleconazole; Intravenous drip was the main route of ADR administration, accounting for the occurrence time of 74.48%.ADR, mostly within 2 weeks (86.19%). In the ADR evaluation of 360 cases with liver injury type, the main type was hepatocyte injury type (93.33%). Most cases were cured and improved (82.17%) after drug withdrawal and symptomatic treatment. Conclusion: cephalosporins, fluoroquinolones, antituberculous drugs and antifungal drugs may be the main drugs causing DILI induced by antiinfective drugs. Clinical medical staff should raise the awareness of anti-infection drug-induced DILI and strengthen prevention.
【作者单位】：北京大学药学院药事管理与临床药学系;解放军总医院药品保障中心;
【分类号】：R575

【共引文献】