本文關(guān)鍵詞：中草藥致藥物性肝損害的臨床特點(diǎn)與病理分析，由筆耕文化傳播整理發(fā)布。

中草藥致藥物性肝損害的臨床特點(diǎn)與病理分析 鄭俊福，劉暉，丁惠國

鄭俊福、丁惠國，首都醫(yī)科大學(xué)附屬北京佑安醫(yī)院肝病消化科，100069；劉暉，首都醫(yī)科大學(xué)病理中心

摘要:目的　以西藥為對照，分析中草藥致藥物性肝炎的臨床與病理特點(diǎn)。方法　回顧性分析臨床診斷藥物性肝損害66例，男29例，女37例，年齡8～65歲。全部患者經(jīng)肝臟穿刺活檢病理學(xué)診斷，肝組織細(xì)胞角蛋白(CK)、HBsAg免疫組織化學(xué)染色，記錄用藥史及肝臟生化指標(biāo)。結(jié)果　藥物性肝損害中中草藥(包括中成藥)所致32例，占48.5%；中西藥合用所致7例，藥物種類以治療月經(jīng)失調(diào)、骨關(guān)節(jié)病及皮膚病為主，占43.8%；西藥所致27例，占40.9%，以解熱鎮(zhèn)痛藥、抗精神病藥、抗生素為主，占74%。致藥物性肝損害以肝細(xì)胞型為主，中草藥占56.3%，西藥占51.9%。中、西藥引起的肝損害臨床類型及臨床表現(xiàn)差異無統(tǒng)計學(xué)意義。免疫組化顯示，CK 陽性21 例(31.8%)，全部病例肝組織HBsAg為陰性。結(jié)論　中草藥是近年來導(dǎo)致藥物性肝損害的重要原因，臨床特點(diǎn)及肝臟病理與西藥相似，要高度重視中草藥的安全性。

關(guān)鍵詞:肝炎，慢性，藥物性；　中草藥；　病理學(xué)，臨床

Department of Hepatology and Gastroenterology，and Pathology，Beijing Youan Hospital，Capital Medical University，Beijing 100069，China

Abstract:Objective　To analyse the clinical and pathological characteristics in Chinese herbal drug-induced hepatitis patients.Methods　Sixty-six drug-induced hepatitic patients were retrospectively analysed.Male/female was 29/37，the average age was 41.27 years old.All patients were received liver biopsy for pathological diagnosis，immunohistochemistry staining for CK and HBsAg.The detailed clinical data，including drug history，liver biochemical data were recorded.Results　Chinese herbal medicine (including proprietary)-induced hepatitic patients was 32，accounting for 48.5%.7 cases had combination of Chinese and Western medicines.Major drugs were for treatment menstrual disorders，bone and joint diseases and skin diseases，accounting for 43.8%.Western drug-induced hepatitic patients was 27，accounting for 40.9%.Major were anti-inflammatory，anti-psychotics drugs，antibiotics，accounting for 74%.The type of liver cell injury was more common in Chinese herbal drug-induced hepatitis，accounting for 56%，，similarity with western drug-induced hepatitis (51.8%).Immunohistochemistry staining showed CK-positive in 21 cases (31.8%)，all cases of liver tissue HBsAg was negative.Conclusions　Chinese herbal drug-induced hepatitis is the main cause of drug-induced liver disease.No difference in clinical and pathological characteristics between Chinese herbal and western drug-induced liver injury are observed.safety of Chinese herbal drug should be cautious in clinical setting.

Keywords:Hepatitis，chronic，drug-induced；　Drugs，chinese herba；　Pathology，clinical

  本文關(guān)鍵詞：中草藥致藥物性肝損害的臨床特點(diǎn)與病理分析，由筆耕文化傳播整理發(fā)布。