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首页> 外文期刊>European journal of gastroenterology and hepatology >Drug-induced acute liver failure.
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Drug-induced acute liver failure.

机译：药物引起的急性肝衰竭。

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Acute liver failure is the most severe expression and represents the first cause of fatalities related to drugs. As a consequence, it is also the first cause of drug withdrawal from the pharmaceutical market. The incidence of drug-induced hepatotoxicity in the general population has been recently estimated to be around 14/100 000 inhabitants in a Western country. Drugs appear to be responsible for 10-52% of all causes of acute liver failure. In Western countries, paracetamol (acetaminophen) represents the first cause of all liver failures. The contribution of non-paracetamol drugs given at normal doses is equivalent to that of combined viral hepatitis A and B. The natural prognosis varies between drugs. The spontaneous mortality rate ranges from 32% to 50% for paracetamol intoxication and more than 75% for other drugs. The preventive occurrence of drug hepatotoxicity and the course to acute liver failure is rather limited. It is recommended to stop the administration of a suspected drug when alanine aminotransferase levels increase to more than 3-5 times the upper limit of normal. In paracetamol intoxication, the rapid administration of N-acetylcysteine is a classical antidote. At the stage of liver failure, treatment is mostly supportive. Since irreversible damage is unpredictable, early transfer to a transplantation centre should be considered.
机译：急性肝衰竭是最严重的表现，并且是与药物有关的死亡的首要原因。结果，它也是药物从制药市场撤出的首要原因。最近据估计，在西方国家，普通人群中药物引起的肝毒性的发生率约为14/100 000。药物似乎在所有急性肝衰竭的原因中占10-52％。在西方国家，扑热息痛（对乙酰氨基酚）是所有肝功能衰竭的首要原因。正常剂量的非对乙酰氨基酚药物的贡献与甲型和乙型病毒性肝炎的总和相当。两种药物的自然预后不同。扑热息痛中毒的自发死亡率为32％至50％，其他药物超过75％。预防药物肝毒性和急性肝衰竭的过程相当有限。当丙氨酸氨基转移酶水平增加到正常上限的3-5倍以上时，建议停止服用可疑药物。在扑热息痛中毒中，N-乙酰半胱氨酸的快速给药是经典的解毒剂。在肝衰竭阶段，治疗主要是支持性的。由于不可挽回的损害是不可预测的，因此应考虑尽早转移到移植中心。

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