Kang Sun Hyung, Kim Jeong Il, Jeong Kyung Hye, Ko Kwang Hoon, Ko Pyung Gohn, Hwang Se Woong, Kim Eun Mi, Kim Seok Hyun, Lee Heon Young, Lee Byung Seok
Department of Gastroenterology and Hepatology, College of Medicine, Chungnam National University, Daejeon, Korea.
Korean J Hepatol. 2008 Dec;14(4):483-92. doi: 10.3350/kjhep.2008.14.4.483.
BACKGROUNDS/AIMS: Toxic hepatitis has recently been discovered to be a major cause of acute hepatitis. We studied the clinical features and prognosis of patients diagnosed with toxic hepatitis at a single institution.
A retrospective analysis was performed using medical records of 159 cases of toxic hepatitis that were diagnosed from March 2003 to March 2008. Patients were selected based on a RUCAM score of 4 or above.
The incidence was higher in women (n=97) than in men (n=62). The age (mean+/-SD) of the patients was 51+/-15 years . The major causes of the disease included the use of Korean traditional therapeutic preparations (34.0%), herbal medicines (41.5%), and drugs prescribed by a physician (23.9%). At the time of admission, jaundice was the most common symptom (41.5%), and the results of a liver serum battery were as follows: aspartate aminotransferase, 729.4+/-877.0 IU/L; alanine aminotransferase, 857.1+/-683.0 IU/L; total bilirubin, 6.4+/-6.5 mg/dL; and alkaline phosphatase, 209.8+/-130.0 IU/L. The hospitalization period was 10.0+/-9.5 days, and the duration of recovery from liver injury was 31.0+/-29.5 days. The factors associated with the hospitalization period included the presence of anorexia and the serum levels of albumin and bilirubin at the time of admission (P<0.05). A high serum bilirubin level and a history of alcohol ingestion were associated with a delayed recovery (Plt;0.05). The sex, age, BMI, and duration of medication were not significantly related to the hospitalization and recovery periods.
The main cause of acute toxic hepatitis in the current study was the use of herbal medicines. The severity of liver injury at the time of admission was a major factor significantly associated with the hospitalization and recovery periods.
背景/目的:毒性肝炎最近被发现是急性肝炎的主要病因。我们研究了在单一机构中被诊断为毒性肝炎患者的临床特征及预后情况。
采用回顾性分析方法,分析了2003年3月至2008年3月期间诊断的159例毒性肝炎患者的病历。根据药物不良反应因果关系评估量表(RUCAM)评分4分及以上选取患者。
女性(n = 97)的发病率高于男性(n = 62)。患者年龄(均值±标准差)为51±15岁。该病的主要病因包括使用韩国传统治疗制剂(34.0%)、草药(41.5%)和医生开具的药物(23.9%)。入院时,黄疸是最常见的症状(41.5%),肝脏血清检查结果如下:天冬氨酸转氨酶,729.4±877.0 IU/L;丙氨酸转氨酶,857.1±683.0 IU/L;总胆红素,6.4±6.5 mg/dL;碱性磷酸酶,209.8±130.0 IU/L。住院时间为10.0±9.5天,肝损伤恢复时间为31.0±29.5天。与住院时间相关的因素包括入院时是否存在厌食以及血清白蛋白和胆红素水平(P<0.05)。血清胆红素水平高和有饮酒史与恢复延迟相关(P<0.05)。性别、年龄、体重指数和用药时间与住院时间和恢复时间无显著相关性。
本研究中急性毒性肝炎的主要病因是草药的使用。入院时肝损伤的严重程度是与住院时间和恢复时间显著相关的主要因素。