药物性肝损伤后的长期预后
Long-Term Outcomes After Drug-Induced Liver Injury.
作者信息
Hayashi Paul H, Bjornsson Einar S
机构信息
division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina.
Division of Gastroenterology and Hepatology, The National University Hospital of Iceland, Reykjavik, Iceland.
出版信息
Curr Hepatol Rep. 2018 Sep;17(3):292-299. doi: 10.1007/s11901-018-0411-0. Epub 2018 Jul 2.
PURPOSE OF THE REVIEW
This review serves to update the reader on emerging data regarding a spectrum of drug-induced liver injury (DILI) outcomes that lie between complete resolution and acute liver failure. Such outcomes can range from mild chronic injury to late liver failure and mortality.
RECENT FINDINGS
Several large registries are maturing with large numbers of DILI cases thus shedding light on outcomes including chronic injury and late fatality. We cover definitions commonly used to describe resolution versus chronic injury and mortality due to DILI. We look at rates of occurrence for these different outcomes in major registries. Three specific types of chronic DILI that are illustrative but also easily missed by clinicians are also described.
SUMMARY
A small but important proportion of DILI cases do not resolve, going on to develop chronic injury and even liver failure. Defining and recognizing these cases is a challenge because DILI is rare, and chronic injury rarer still. Large registries are beginning to define these previously overlooked long term outcomes.
综述目的
本综述旨在向读者介绍有关一系列药物性肝损伤（DILI）结局的新出现数据，这些结局介于完全恢复和急性肝衰竭之间。此类结局范围可从轻度慢性损伤到晚期肝衰竭和死亡。
最新发现
几个大型登记处正在不断完善，积累了大量DILI病例，从而使包括慢性损伤和晚期死亡在内的结局得以明晰。我们涵盖了常用于描述DILI恢复与慢性损伤及死亡的定义。我们查看了主要登记处中这些不同结局的发生率。还描述了三种具有代表性但临床医生也容易漏诊的慢性DILI具体类型。
总结
一小部分但很重要的DILI病例无法恢复，继而发展为慢性损伤甚至肝衰竭。定义和识别这些病例具有挑战性，因为DILI很罕见，慢性损伤更是罕见。大型登记处正开始明确这些先前被忽视的长期结局。
Zotero 插件