【摘要】 目的:研究探讨引起药物性肝损害的常见药物及影响因素,为临床预防提供参考。方法:从江苏省药品不良反应中心的报表数据库中选取644例药物性肝损害病例与644例对照病例。应用1∶1匹配病例对照研究方法,对样本病例进行单因素及多因素条件Logistic回归分析,进而探讨药物性肝损害发生的影响因素。结果:经单因素分析共初步筛选12个具有统计学意义的影响因素,对该12个因素进行多因素条件Logistic回归分析,结果显示其中有9个因素易导致药物性肝损害的发生,其OR值(95%CI)分别为合并用药3.089(2.038～4.683),抗结核药37.496(10.873～129.302),抗真菌药8.197(2.876～23.364),抗病毒药8.687(1.831～41.214),抗精神病药2.789(1.081～7.194),抗癫痫药5.674(1.116～28.844),抗肿瘤药7.103(3.796～13.292),主要作用于心血管系统的药物2.314(1.237～4.330),激素及其有关药物3.954(1.921～8.139)。结论:临床治疗中应警惕抗结核药物、抗真菌药、抗病毒药、抗精神病药、抗癫痫药、抗肿瘤药、主要作用于心血管系统药物、激素及其相关药物的使用,合并使用药物时要注意药物之间的相互作用,必要时可对患者的肝功能进行监测,避免或减少药物性肝损害的发生。更多还原

【Abstract】 Objective: To investigate the common drugs and influence factors of the drug-induced liver injury for providing references of clinical prevention.Methods: A total of 644 patients with drug-induced liver injury and 644 control patients were selected from the date base of the Adverse Drug Reaction Monitoring Center of Jiangsu Province.With the application of 1∶1 matched case-control study,the single factor analysis and conditional logistic regression analysis to the data were performed to find the influence factors of the occurrence of drug-induced liver injury.Results: Through the single factor analysis,12 statistically significant influence factors were preliminarily screened out.Then these 12 influence factors were taken into conditional logistic multivariate analysis.The result showed that 9 of these factors were easy to cause the occurrence of drug-induced liver injury.Their OR values(95% CI) were: drug combination 3.089(2.038~4.683),antituberculotic drugs 37.496(10.873~129.302),antiviral drugs 8.687(1.831~41.214),antifungal agents 8.197(2.876~23.364),antipsychotic drugs 2.789(1.081~7.194),antiepileptic drugs 5.674(1.116~28.844),antineoplastic drugs 7.103(3.796~13.292),cardioactive and vasoactive medicines 2.314(1.237~4.330) and hormones and related drugs 3.954(1.921~8.139).Conclusion: The use of antituberculotic,antiviral,antifungal,antipsychotic,antiepileptic and antineoplastic drugs,cardioactive and vasoactive medicines,or hormones and related drugs should be alert in clinical therapies.The doctor should mind the drug interactions in the use of combinations of drugs.In case of necessity,the monitoring of liver function should be taken to avoid the occurrence of drug-induced liver injury.更多还原