目的 探讨药物性肝损伤(DILI)的病因构成、临床特点及预后因素.方法 根据Roussel Uclaf因果关系评估(RUCAM)量表纳入2012年1月至2015年3月住院治疗的205例患者,回顾性分析其临床资料.结果 引起DILI的前三位药物为:中药92例(44.87%)、抗结核药41例(20.00%)、抗菌药物14例(6.82%).患者临床表现无特异性,以肝细胞损伤型DILI最常见,共126例(61.46%),胆汁淤积型67例(32.68%),混合型12例((5.85%).205例患者中,190例达到治愈或好转,有效率为92.68%,其中肝衰竭型预后最差.结论 本组患者因中药引起的DILI所占比例最高,其次为抗结核药及抗菌药物,绝大部分DILI患者临床预后较好.%Objective To analyze the etiology ,clinical features and prognosis of liver injuries caused by different drugs .Methods According to the Roussel Uclaf Causality Assessment Method ( RUCAM) scale,clinical outcomes and other associated data were retrospectively assessed for 205 patients with drug-induced liver injury ( DILI) in the Department of Infectious Diseases from January 2012 to March 2015. Results The most prevalent agents inducing DILl were Chinese traditional drugs (44.87%),followed by anti-tuberculosis drugs(20.00%) and antibiotics(6.82%).In general,the clinical manifestations and biochemical results were not specific .The percentages of hepatocellular injury type,cholestatic injury type and mixed injury type were 61.46%,32.68% and 5.85%,respectively.190 patients were cured or im-proved,and the effective rate was 92.68%.The prognosis of the liver failure type was the worst .Conclusion Although anti-tuberculosis drugs (20.00%)and antibiotics are considered as common drugs that can induce DILI ,Chinese traditional drugs have emerged as another im-portant group of liver injuries agents .The majority of patients with DILI have good prognosis .
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