| 药物性肝损伤不良反应分析 |
| 投稿时间：2024-04-09 修订日期：2024-10-29 点此下载全文 |
| 引用本文：张岩,李炎君,刘家荟,邓娇,原苑,张敬一.药物性肝损伤不良反应分析[J].药学实践杂志,2025,43(1):26~29,40 |
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| 作者 | 单位 | E-mail | | 张岩 | 中国人民解放军北部战区总医院器官移植中心, 辽宁 沈阳, 110016 | | | 李炎君 | 中国人民解放军北部战区总医院药剂科, 辽宁 沈阳, 110016 | | | 刘家荟 | 中国人民解放军北部战区总医院药剂科, 辽宁 沈阳, 110016 | | | 邓娇 | 中国人民解放军北部战区总医院药剂科, 辽宁 沈阳, 110016 | | | 原苑 | 中国人民解放军北部战区总医院药剂科, 辽宁 沈阳, 110016 | | | 张敬一 | 中国人民解放军北部战区总医院药剂科, 辽宁 沈阳, 110016 | 13352459792@163.com |
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| 中文摘要:目的 对药物性肝损伤不良反应报告进行分析，探讨药物性肝损伤的特点及相关规律，为临床安全用药提供借鉴。方法 对本院2011年至2021年间上报至医院不良反应监测系统的259例药物所致肝损伤进行帕累托分析。结果 259例ADR报告中，药物性肝损伤最常见类型为肝细胞损伤型（37.84%），引发药物性肝损伤的年龄段主要在46岁以上，共195例（75.28%）。药物种类主要有心血管疾病用药（44.02%）、抗感染药（23.94%）及抗肿瘤药（11.58%）。其中，心血管药物中阿托伐他汀钙40 mg及以上占比最高，共53例（46.49%）；抗感染药物中主要为头孢菌素类（29.03%）、碳青霉烯类（19.35%）、抗真菌类（17.74%）、喹诺酮类（11.29%）。不良反应发生时间主要在用药6 d及以内（69.88%），不良反应持续时间多为1至2周（31.66%）。多数患者好转（47.88%）或治愈（37.07%）。结论 对于中老年患者，应用心血管系统药物、抗感染药物或抗肿瘤药物时，需要至少在6 d及以内监测患者肝功能变化，如有异常应及时停药或给予治疗，从而避免药物性肝损伤的进展。 |
| 中文关键词:药物性肝损伤 药物不良反应 帕累托分析 用药安全性 |
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| Adverse reaction analysis of drug-induced liver injury |
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| Abstract:Objective To analyze the adverse reaction reports （ADRs） of drug-induced liver injury in recent ten years, explore the characteristics and related rules of drug-induced liver injury, and provide reference for clinical safe drug use. Methods ADRs in our hospital from 2011 to 2021 which belonged to drug-induced liver injuries were collected, and Pareto analysis was carried on.Results In 259 ADR reports, the most common type of drug-induced liver injury was hepatocellular injury （37.84%）. The age of drug-induced liver injury was mainly over 46 years, totaling 195 （75.28%）. Drugs were mainly distributed in cardiovascular system medicine （44.02%）, anti-infective medicine （23.94%）and anti-tumor medicine （11.58%）. Among the cardiovascular drugs, atorvastatin calcium 40mg and over 40mg were the highest proportion, with 53 cases （46.49%）. The main anti-infectious drugs were cephalosporins （29.03%）, carbapenem （19.35%）， antifungal （17.74%）and quinolones （11.29%）. Adverse reactions occurred within 6 days （69.88%）, the duration of adverse reactions was 1-2 weeks （31.66%）, and most patients were improved （47.88%） or cured （37.07%）. Conclusion For middle-aged and elderly patients, when the application of cardiovascular system drugs, anti-infective drugs or anti-tumor drugs, it is necessary to monitor the liver function changes of patients for at least 6 days. If there are abnormalities, the drugs should be stopped or given treatment in time, to avoid the progress of drug-induced liver injury. |
| keywords:drug-induced liver injury adverse drug reactions Pareto analysis medication safety |
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