本文選題：藥物性肝損害 + 年齡��； 參考：《中國老年學(xué)雜志》2017年09期

【摘要】：目的探討老年人藥物性肝損害(DILI)的臨床特點。方法選擇84例DILI患者,按年齡分為老年組及中青年組,并進(jìn)行對比分析。結(jié)果老年、中青年DILI患者占同期老年人、中青年肝病患者比例分別為4.77%、2.27%,二者差異顯著(P0.05)。兩組臨床分型亦有差異。老年組黃疸和皮膚瘙癢發(fā)生率較高,與中青年組差異顯著(P0.05)。老年組引起DILI的前5類藥物為:中藥(34.6%)、聯(lián)合用藥(15.4%)、抗微生物藥(11.5%)、抗結(jié)核病藥(11.5%)、激素類藥(7.6%);中青年組依次為:中藥(41.4%)、抗腫瘤藥(12.1%)、抗微生物藥(6.9%)、聯(lián)合用藥(6.9%)、抗甲狀腺藥(6.9%)。兩組初始用藥至發(fā)病的時間、住院天數(shù)、治療前丙氨酸氨基轉(zhuǎn)移酶(ALT)、天冬氨酸氨基轉(zhuǎn)移酶(AST)、總膽紅素(TBIL)、堿性磷酸酶(ALP)值、臨床轉(zhuǎn)歸及預(yù)后均無差異(P0.05)。結(jié)論 DILI在老年肝病患者中的占比高于中青年肝病患者。引起老年人肝損害的藥物以中藥、聯(lián)合用藥、抗微生物藥、抗結(jié)核病藥多見,臨床表現(xiàn)以黃疸和皮膚瘙癢多見,一般預(yù)后較好。
[Abstract]:Objective to investigate the clinical features of drug-induced liver injury (DILI) in the elderly. Methods 84 patients with DILI were divided into two groups according to their age. Results in the elderly, the proportion of young and middle-aged patients with DILI was 4.772.27, and the proportion of young and middle-aged patients with liver disease was 4.770.The difference between them was significant (P 0.05). There were also differences in clinical classification between the two groups. The incidence of jaundice and pruritus in the aged group was higher than that in the middle and young group (P 0.05). The first five kinds of drugs caused by DILI in the elderly group were as follows: Chinese medicine 34. 6%, combined use 15. 4%, antimicrobial drug 11. 5%, antituberculosis drug 11. 5%, hormone drug 7. 6%; in the middle and young group, it was 41.4%, 12. 1%, 6. 9%, 6. 9%, 6. 9%, 6. 9%, 6. 9%, 6. 9% and 6. 9% respectively. There was no significant difference in the clinical outcome and prognosis between the two groups (P < 0.05), such as the time from the onset to the onset, the hospitalization days, the alanine aminotransferase (alt), the aspartate aminotransferase (AST), the total bilirubin (TBILL), the alkaline phosphatase (ALP), the clinical outcome and the prognosis of the two groups. Conclusion the proportion of DILI in elderly patients with liver disease is higher than that in young and middle-aged patients with liver disease. Traditional Chinese medicine, combined use, antimicrobial and anti-tuberculosis drugs are the most common drugs to cause liver damage in the elderly. Jaundice and skin pruritus are the most common clinical manifestations, and the general prognosis is good.
【作者單位】： 南通衛(wèi)生高等職業(yè)技術(shù)學(xué)校藥學(xué)系;南通大學(xué)附屬南通第三醫(yī)院肝病科;
【基金】：江蘇省衛(wèi)生廳青年科研項目(No.Q201208) 江蘇省高�！扒嗨{(lán)工程”資助(2016年)
【分類號】：R575

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