【摘要】 目的：探讨某院药物性肝损伤(DILI)患者的临床特征及保肝药物使用合理性，为临床合理用药提供依据。方法：回顾性分析2023年7月至2024年6月该院收治的DILI患者，收集其年龄、性别、用药史、临床表现、肝脏生化指标、DILI分型、保肝药物使用情况及临床结局等数据，并进行统计分析。结果：2023年7月至2024年6月该院57 089例出院患者中，有36例DILI患者，DILI发病率为0.63‰;可疑药物以中药饮片或中成药、抗肿瘤药和抗感染药为主；DILI分型以肝细胞损伤型为主(28例，占77.78%),严重程度多为轻度(20例，占55.56%)和中度(14例，占38.89%)。保肝药物使用不合理现象较普遍，共35例患者使用保肝药物，其中48.57%的患者(17例)存在适应证不适宜，80.00%的患者(28例)存在联合用药不适宜，45.71%的患者(16例)同时存在适应证不适宜及联合用药不适宜。结论：该院DILI患者的临床特征与国内既往研究一致，但保肝药物的使用存在较多不合理现象。建议依据最新指南规范DILI的诊断和治疗，减少不必要的联合用药，优化医疗费用结构并提高治疗效果。更多还原

【Abstract】 OBJECTIVE: To probe into the clinical characteristics of patients with drug-induced liver injury(DILI) in a hospital and to evaluate the application rationality of hepatoprotective drugs, so as to provide references for clinical rational medication. METHODS: Retrospective analysis was performed on patients with DILI admitted into the hospital from Jul. 2023 to Jun. 2024, ages, genders, medication histories, clinical manifestations, liver biochemical indicators, DILI classifications, application of hepatoprotective drugs and clinical outcomes were collected and statistically analyzed. RESULTS: Among 57 089 discharged patients from Jul. 2023 to Jun. 2024, there were 36 DILI patients, with an incidence of 0.63‰. The suspected drugs were mainly traditional Chinese herbal pieces or Chinese patent medicine, antitumor drugs and anti-infective drugs. The type of DILI was mainly hepatocyte injury(28 cases, 77.78%), and the severity was mild(20 cases, 55.56%) and moderate(14 cases, 38.89%).Irrational application of hepatoprotective drugs was common, 35 patients received hepatoprotective drugs, of which 48.57%(17 cases) with inappropriate indications, 80.00%(28 cases) with inappropriate combined medication, 45.71%(16 cases) with both inappropriate indications and inappropriate combined medication. CONCLUSIONS: The clinical characteristics of DILI in the hospital are consistent with previous domestic studies, while there are some irrational issues with the application of hepatoprotective drugs. It is recommended to standardize the diagnosis and treatment of DILI according to the latest guidelines, reduce unnecessary combined medication, optimize medical cost structures and improve therapeutic effects.更多还原