【摘要】 目的:总结药物性肝损伤的临床病理特点,为今后药物性肝损伤的早诊断、早治疗提供帮助。选取首都医科大学附属北京佑安医院2008年全年收治并确诊为药物性肝损伤的病例121例,所有病例均做过肝穿刺组织病理学检查及相关血清学检查,进行回顾性研究。结果:引起D ILI的药物种类很多,中成药最多见;乏力、黄疸、转氨酶升高是最常见的临床表现;D ILI的病理特点为中央静脉周围,即小叶Ⅲ带出现肝细胞脱失、坏死,同时常伴有kupffer细胞增生或淤胆,坏死区炎症反应轻,汇管区混合性炎细胞浸润,嗜酸性粒细胞多见;有肝病史的患者更易发生药物性肝损伤。结论:熟悉药物毒副作用,详细询问用药史,以及条件允许的情况下尽早行肝穿刺组织病理学检查是明确诊断、及时治疗的最好办法。更多还原

【Abstract】 Objective: To summarize clinical pathology feature of DILI and to provide helpful guide for early diagnosis and ther Kapy of DILI.Methods: 121 cases,diagnosed as drug-induced liver injury in Beijing Youan Hospital in 2008 with liver biopsy and serology results,were retrospectively investigated.Results: Many kinds of drug can cause DILI,Chinese traditional medicine are the most common one.Fatigue,jaundice,elevated transaminase were the most common clinical manifestations;Pathological features of DILI are hepatocyte loss,necrosis around the central vein(liver lobule Ⅲ),often accompanied by kupffer cell proliferation or cholestasis,mild inflammatory response in necrotic area,mixed inflammatory cell infiltration in hepatic portal area,eosinophils frequently seen;patients with history of liver disease are more susceptible to drug-induced liver injury.Conclusion: Asking about previous concomitant medication as well as conducting liver biopsy as soon as possible is the best way to get puncture diagnosis and identify proper treatment of DILI in time.更多还原