本文選題：低分子肝素 + 藥物性肝損傷��； 參考：《中國(guó)臨床藥理學(xué)雜志》2017年17期

【摘要】：目的探討低分子肝素(LMWH)引起急性藥物性肝損傷(DILI)的臨床特征及預(yù)后因素。方法根據(jù)國(guó)際公認(rèn)的Roussel Uclaf因果關(guān)系評(píng)估方法(RUCAM)2015版,收集我院使用低分子肝素治療肺血栓栓塞癥(PTE)引起急性DILI的住院患者基本信息、醫(yī)囑、實(shí)驗(yàn)室檢查結(jié)果等資料。結(jié)果共納入患者92例,其中82.61%的DILI患者經(jīng)RUCAM評(píng)分判斷為"非常可能"和"很可能"(≥6分)。DILI分型診斷中肝細(xì)胞型18例(19.57%),混合型45例(48.91%),膽汁淤積型29例(31.52%)。基本資料統(tǒng)計(jì)顯示,3組間谷丙轉(zhuǎn)氨酶、谷草轉(zhuǎn)氨酶、堿性磷酸酶和總膽紅素水平差異有統(tǒng)計(jì)學(xué)意義(P0.05)。多因素回歸顯示,伴重癥感染(P0.05)是低分子肝素引起混合型DILI的不良預(yù)后因素,高血肌酸酐(Scr)水平(P0.05)是低分子肝素引起肝細(xì)胞型DILI的不良預(yù)后因素。用藥后發(fā)生DILI時(shí)間、實(shí)驗(yàn)室指標(biāo)異常達(dá)峰時(shí)間、轉(zhuǎn)歸時(shí)間和結(jié)局在3種DILI類(lèi)型間差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論當(dāng)使用低分子肝素治療PTE患者同時(shí)伴隨重癥感染和/或高Scr水平時(shí),應(yīng)加強(qiáng)對(duì)DILI的監(jiān)護(hù)與判斷,必要時(shí)根據(jù)DILI分型對(duì)癥處理。
[Abstract]:Objective to investigate the clinical features and prognostic factors of acute drug-induced liver injury induced by low molecular weight heparin (LMWHs). Methods according to the internationally accepted Roussel Uclaf causality assessment method, Rucam 2015, we collected the basic information, medical advice and laboratory results of patients with acute DILI who were treated with low molecular weight heparin (LMWH). Results 92 patients were included, of whom 82.61% of DILI patients were diagnosed as "very likely" and "very likely" by RUCAM score (鈮，

本文編號(hào)：1842531