中国临床药理学杂志2017，Vol.33Issue(17)：1621-1624,4.DOI:10.13699/j.cnki.1001-6821.2017.17.003
低分子肝素治疗肺血栓栓塞症引起急性药物性肝损伤的临床特征及预后因素分析
Analysis of clinical features and prognostic factors of acute drug induced liver injury associated with low molecular weight heparin
赵紫楠 1张亚同 1胡欣1
作者信息
- 1. 北京医院药学部、国家老年医学中心,北京100730
- 折叠
摘要
Abstract
Objective To explore the clinical features and prognostic factor of acute drug induced liver injury (DILI) associated with low molecular weight heparin (LMWH) in pulmonary thromboembolism patients.Methods International recognized Roussel Uclaf causality assessment method 2015 (RUCAM) was taken as standard.Basic clinical date,prescriptions and laboratory of pulmonary thromboembolism (PTE) patients in use of LMWH was collected and analyzed.Results Among 92 patients with acute DILI,according to RUCAM,there were 82.61％ with quite high probability and high probability (≥6).The hepatocellular injury type accounted for 18 patients (19.57％),mixed type accounted 45 patients (48.91％) and cholestatic type of DILI accounted for 29 patients (31.52％).Basic analysis showed the levels of alanine transaminase (ALT),aspartate aminotransferase (AST),alkaline phosphatase (ALP) and total bilirubine (TBIL) had statistically significant difference among 3 groups (P ＜ 0.05).Multivariate analysis indicated that severe infection (P ＜ 0.05) and high level of serum creatinine (Scr,P ＜ 0.05) were the independent adverse prognostic factors of mixed type and hepatocellular injury type of DILI,respectively.There was no statistically significant difference in the time to apparent onset of the reaction,the time upon the top level of abnormal liver function and outcomes among the 3 groups of DILI (P ＞ 0.05).Conclusion It is necessary to dynamically evaluate the liver function during hospitalization especially patients are with severe infection and/or high level of Scr.Specific treatment can be necessary in according with the type of DILI.关键词
低分子肝素/药物性肝损伤/肺血栓栓塞症/预后因素/风险评估Key words
low molecular weight heparin/drug induced liver injury/pulmonary thromboembolism/prognostic factor/risk evaluation分类
医药卫生引用本文复制引用
赵紫楠,张亚同,胡欣..低分子肝素治疗肺血栓栓塞症引起急性药物性肝损伤的临床特征及预后因素分析[J].中国临床药理学杂志,2017,33(17):1621-1624,4.
