目的:探讨儿童药物性肝损害(DILI)的临床特点。方法:采用回顾性描述性研究方法收集5年住院患儿DILI的临床资料,对患儿的一般状况、用药史、临床表现、肝脏损害类型以及原发疾病等相关因素进行分析,探讨儿童DILI的临床特点。结果:641例因肝脏疾病住院的患儿中,DILI患儿64例,占10%。肝脏损害的类型以肝细胞型为主,占81%;引起肝脏损害的药物主要为化疗药物、抗生素、抗结核药物;临床常见的症状及体征有皮疹(16%)、消化道症状(15%)、发热(14%)和肝脏肿大(12%),其中11%的DILI患儿无症状及体征。结论:DILI是住院儿童肝脏损害的常见原因之一,部分DILI患儿仅有肝功能生化指标异常而无症状及体征。儿童DILI以肝细胞型为主,肝脏损害较轻。
Abstract
OBJECTIVE: To study the clinical features of drug-induced liver injury in children. METHODS: The clinical data of the hospitalized children with drug-induced liver injury over 5 years were retrospectively reviewed. RESULTS: Of 641 cases of hospitalized children with liver injury, there were 64 cases (10%) of drug-induced liver injury. Hepatocellular injury was the most common type of drug-induced liver injury (81%). The major drugs causing drug-induced liver injury included chemotherapy drugs, antibiotics and anti-tuberculosis drugs. Rash (16%), gastrointestinal reaction (15%), fever (14%) and liver intumescence (12%) were common clinical symptoms. A part of patients with drug-induced liver injury (11%) had no symptoms and signs. CONCLUSIONS: Drug-induced liver injury is one of the common causes of liver damage in hospitalized children. Some children with drug-induced liver injury have no symptoms and signs. Hepatocellular injury is a major type of drug-induced liver injury in children, resulting less severe liver damage.
关键词
药物性肝损害 /
临床特点 /
儿童
Key words
Drug-induced liver injury /
Clinical feature /
Child
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