De Valle M B, Av Klinteberg V, Alem N, Olsson R, Björnsson E
Department of Internal Medicine, Section of Gastroenterology and Hepatology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
Aliment Pharmacol Ther. 2006 Oct 15;24(8):1187-95. doi: 10.1111/j.1365-2036.2006.03117.x.
Limited data exist on the proportion of drug-induced liver injury among out-patients seen in a hepatology clinic.
To determine the proportion of drug-induced liver injury cases, and identify the most important agents and the nature of the liver injury.
A computerized diagnoses database in an out-patient hepatology clinic in a Swedish University hospital was analysed during the period 1995-2005. All suspected drug-induced liver injury cases were causality assessed with the International Consensus Criteria.
A total of 1164 cases were seen for the first time during this period. Drug-induced liver injury with at least a possible causal relationship was found in 77 cases (6.6%), 38 (3.3%) of whom were referred for evaluation to the out-patient clinic whereas 3% had a follow-up after hospitalization of drug-induced liver injury. The median age was 58 years, 43 (56%) were females, a hepatocellular pattern was observed in 37 cases (48%), cholestatic in 31 (40%) and mixed in 12%. Antibiotics were the most common agents causing drug-induced liver injury followed by non-steroidal anti-inflammatory drugs, with diclofenac most often responsible for the drug-induced liver injury.
Drug-induced liver injury cases constituted 6% of all out-patients and 3% of referrals and occurred more often in women. Antibiotics and diclofenac were the most common causes of drug-induced liver injury among out-patients.
关于肝病门诊中药物性肝损伤患者比例的数据有限。
确定药物性肝损伤病例的比例，识别最重要的致病药物及肝损伤的类型。
对瑞典一家大学医院门诊肝病科1995年至2005年期间的计算机诊断数据库进行分析。所有疑似药物性肝损伤病例均按照国际共识标准进行因果关系评估。
在此期间共首次接诊1164例患者。发现77例（6.6%）存在至少可能有因果关系的药物性肝损伤，其中38例（3.3%）被转诊至门诊进行评估，3%在药物性肝损伤住院治疗后进行了随访。中位年龄为58岁，43例（56%）为女性，37例（48%）表现为肝细胞型，31例（40%）为胆汁淤积型，12%为混合型。抗生素是导致药物性肝损伤最常见的药物，其次是非甾体类抗炎药，其中双氯芬酸最常导致药物性肝损伤。
药物性肝损伤病例占所有门诊患者的6%，占转诊患者的3%，且在女性中更为常见。抗生素和双氯芬酸是门诊患者药物性肝损伤最常见的病因。
