西药与中药所致药物性肝损伤临床特征对比

摘要

目的：探析西药与中药所致药物性肝损伤的临床特征。方法回顾性分析2012年3月至2014年3月医院收治的120例因服药所致肝损伤的患者资料，其中中药组55例，西药组65例。对比两组患者服药期间的临床表现、不良反应、预后及实验室检查结果等。结果中、西药均有多种药物能导致药物性肝损伤，其中中药类消核片以及西药类抗结核药占比最高，分别为34.55％（19/55）和43.08％（28/65）。两组患者均出现不同程度的不良反应，西药组出现黄疸35例（53.85％）、乏力14例（21.54％）、纳差16例（24.62％），中药组分别为18例（32.73％）、27例（49.09％）、5例（9.09％）。中药组的丙氨酸氨基转移酶( ALT )为（568.9±214.8）U/L，谷氨酰转移酶( GGT )为（609.5±234.6）U/L，均显著高于西药组的（387.5±127.9）U/L和(518.2±218.5) U/L（ P＜0.05），两组的总胆红素( TBIL )无明显差异（ P＞0.05）。随访半年后，中药组出现4例肝衰竭，西药组并未出现肝衰竭(χ2＝3.64，P＜0.05）。结论中药与西药导致的肝损伤在临床表现、实验室检查结果与预后均有不同，并具一定特征。%Objective To analyze the clinical characteristics of drug-induced liver injury caused by western medicine and traditional Chinese medicine ( TCM ) . Methods The analytical review was conducted to the 120 cases with liver injury induced by western medicine and traditional Chinese medicine from March 2012 to March 2014 including 55 cases in the TCM grouP,and 65 cases in the western medicine grouP. The adverse reactions,Prognosis and clinical manifestation,laboratory examination results of the two grouP were comPared and analyzed. Results Take drugs for classified summary,both TCM and western medicine could cause drug-induced liver damage,and the TCM tuberculosis elimination medicine and western anti-tb drugs accounted for the highest,34. 55%( 19/55 ) and 43. 08%( 28/65 ) resPectively. The two grouPs had different degrees of adverse reactions,with 35 cases aPPeared icteric 35 cases ( 53. 85% ) ,14 cases lacking in strength ( 21. 54% ) ,16 cases Poor in aPPetite ( 24. 62% ) in the western medicine grouP,the number were 18 cases ( 32. 73% ) ,27 cases ( 49. 09% ) ,5 cases ( 9. 09% ) in the TCM grouP resPectively. The ALT was ( 568. 9 ± 214. 8 ) U/L,GGT was (609. 5 ± 234. 6)U/L in Traditional Chinese Medicine grouP,which were significantly higher than ( 387. 5 ± 127. 9 ) U/L and ( 518. 2 ± 218. 5 ) U/L in the western medicine grouP,the differences were statistically significant ( P 0. 05 ) . After six months follow-uP,the Traditional Chinese Medicine grouP had 4 cases of liver failure, the western medicine grouP did not aPPear any hePatic failure (χ2=3. 64,P < 0. 05 ) . Conclusion Liver injury caused by traditional Chinese medicine and western medicine are different in clinical and Prognosis manifestation,laboratory examination results,and have certain features that are worth for clinical reference.