抗精神病药致肝功能损害的相关因素分析

摘要

Objective: To explore the relevant factors in liver function injury caused by the antipsychotic drugs. Method:Investigate the probability of liver injury after the treatment of antipsychotic drugs in hospitalized patients with schizophrenia during the year of 2008. Results:Liver injury was more likely happened in patients such as men, the elderly, hepatitis B virus carrier, accompanied by serious chronic diseases, long-term medication, chronic schizophrenia. The risk of liver injury caused by atypical antipsychotics was lower than typical antipsychotics. There was direct correlation between drug dose and liver injury. Drug combination could cause liver injury more easily. Liver injury mostly occurred within 30 days after the treatment of antipsychotic drugs. Mild to moderate bepatocllular hepatic dysfunction was more common. The type-B ultrasonic of liver and gallbladder changed seldom after liver injury. Acute severe liver injury may be related to the bedy's allergic reaction or idiosyncratic response to drugs. Conclusion:The pathogenesis of antipsychotic-induced liver injury is correlated with the patients variety of self factors and external factors.%目的:探讨抗精神病药致肝功能损害的相关因素.方法:使用回顾性研究的方法,调查2008年住院精神病患者中使用抗精神病药后肝功能损害的发生率,并使用卡方检验、logistic回归分析等方法来进行统计分析.结果:男性、老年人、乙肝病毒携带、严重慢性病史、长期服药、病程较长的患者在用药后更容易出现肝功能损害;非典型抗精神病药致肝功能损害的风险明显小于经典抗精神病药,所用药物剂量越大,出现肝功能损害的风险也越大,联用药物更易致肝功能损害.肝功能损害出现的时间多在30 d内,轻、中度肝细胞型肝功能损害多见,极少伴有明显的肝胆B超改变.急性重度肝功能损害可能与机体对药物的过敏反应或特异质反应有关.结论:在抗精神病药致药源性肝功能损害中,患者自身因素和治疗用药等外在因素均占有重要地位.