Epidemiology of drug-induced liver injury
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摘要: 药物性肝损伤(DILI)的发病率逐年上升,目前已成为临床常见的肝病之一, 受到全世界范围的广泛关注。已知多种药物,包括中草药和膳食补充剂均可导致各种类型的急慢性肝损伤,重者可出现急性肝衰竭,导致死亡或接受肝移植。就DILI的全球流行情况及常见可疑药物的分布进行了阐述。
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关键词:
- 化学性与药物性肝损伤 /
- 流行病学研究 /
- 回顾性研究 /
- 前瞻性研究
Abstract: The incidence rate of drug-induced liver injury (DILI) is increasing year by year, and DILI has become one of the common liver diseases in clinical practice and has attracted the attention of the whole world. It is known that a variety of drugs, including Chinese herbal medicine and dietary supplements, can cause various types of acute or chronic liver injury, and acute liver failure may occur in severe cases, leading to death or liver transplantation. This article elaborates on the global prevalence of DILI and the distribution of common suspected drugs. -
表 1 全球DILI流行病学现状
研究 研究类型 持续年份 年发
病率DILI总数
(例)女性
(%)主要年龄分布(岁) 慢性患者(%) 肝细胞型/
胆汁淤积型/
混合型(%)病死率
(%)主要诱发DILI药物(%) 冰岛 前瞻性 2010年—2011年 19.1/10万 96 56.25 40~59 7 42/32/26 1.04 抗菌药物(37.0)、HDS (16.0)、非甾体抗炎药(6.0) 法国 前瞻性 1997年—2000年 13.9/10万 34 64.7 ≥50 47.1/20.6/26.5 5.88 抗感染药物(25.0)、精神药物(22.5)、降血脂药物(12.5)和非甾体抗炎药(10.0) 美国 前瞻性 2004年—2013年 2.7/10万
成年人,
特拉华州899 59 18 54/23/23 6 抗菌药物(45.4)、HDS(16.1)、心血管系统药物(9.8)、中枢神经系统药物(9.1) 西班牙 前瞻性 1994年—2004年 3.42/10万 461 48.65 ≥60 10.31 57.8/20.0/22.2 5.38 阿莫西林-克拉维酸(13.23)、结核病药物(6.95)、依溴替丁(4.93) 瑞典 回顾性 1970年—2004年 2.4/10万 784 57.7 52.2/26.3/21.5 9.18 抗生素(27.04)、非甾体抗炎药(4.85)、麻醉药(1.91) 印度 回顾性 1997年—2008年 313 42 0.32 17.3 结核病药物(57.8)、苯妥英钠(6.7)、奥氮平(5.4)、氨苯砜(5.4) 日本 回顾性 1997年—2006年 1676 57 50~69 59/20/21 0.4 抗生素(14.3)、精神药物和神经系统药物(10.1)、HDS(10.0) 中国 回顾性 2012年—2014年 23.80/10万 25 927 49.17 40~59 13 51.39/20.31/28.30 0.39 传统中药或HDS(26.81)、抗结核药物(21.99)、抗肿瘤药物或免疫调节剂(8.34)、抗感染药物(6.08) -
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