Wai Chun-Tao, Tan Bee-Him, Chan Cheng-Leng, Sutedja Dede S, Lee Yin-Mei, Khor Christopher, Lim Seng-Gee
Asian Center for Liver Diseases and Transplantation, Gleneagles Hospital, Singapore, Singapore.
Liver Int. 2007 May;27(4):465-74. doi: 10.1111/j.1478-3231.2007.01461.x.
BACKGROUND/AIMS: The aetiology of drug-induced liver injuries (DILI) in Asia is different from that in the West, as anecdotal studies have shown that traditional complementary and alternative medicines (CAM) accounted for a major proportion of offending drugs in DILI in Asia. We aimed to study DILI in Asia prospectively, and to test whether DILI caused by traditional CAM was related to adulterants.
A collaborative group consisting of a tertiary-hospital hepatology department, a pharmaceutical laboratory, and a pharmacovigilance unit was formed to study patients with DILI at a tertiary hospital over a 26-month period prospectively. Traditional medicines that were implicated were tested for the presence of adulterants.
Thirty-one patients with DILI were enrolled: age 51+/-3 (18-79) years, 17 (55%) male. Twenty-three (74%) had hepatocellular, six (19%) had cholestatic, and two (7%) had a mixed pattern of injury. Chinese traditional CAM was the most common medication type implicated, accounting for 17 (55%) patients, followed by Malay CAM in five (16%). Thirty-one traditional medicines from 17 patients were available for chemical analysis. Adulterants were found in nine (29%) of them.
DILI in Asia has a different aetiology as compared with the West, and could be related to presence of adulterants in traditional CAM.
背景/目的：亚洲药物性肝损伤（DILI）的病因与西方不同，因为轶事研究表明，传统补充和替代医学（CAM）在亚洲DILI的致病药物中占很大比例。我们旨在对亚洲的DILI进行前瞻性研究，并测试传统CAM引起的DILI是否与掺假物有关。
成立了一个由三级医院肝病科、药物实验室和药物警戒部门组成的协作组，对一家三级医院26个月期间的DILI患者进行前瞻性研究。对涉及的传统药物进行掺假物检测。
纳入31例DILI患者：年龄51±3（18 - 79）岁，17例（55%）为男性。23例（74%）为肝细胞损伤型，6例（19%）为胆汁淤积型，2例（7%）为混合型损伤。中国传统CAM是最常见的致病药物类型，占17例（55%）患者，其次是马来CAM，占5例（16%）。17例患者的31种传统药物可供化学分析。其中9种（29%）发现有掺假物。
与西方相比，亚洲的DILI病因不同，可能与传统CAM中存在掺假物有关。
