实用肝脏病杂志2024，Vol.27Issue(4)：547-550,4.DOI:10.3969/j.issn.1672-5069.2024.04.014
老年药物性肝损伤患者临床特征分析
Clinical feature of elderly patients with drug-induced liver injury:An analysis of 44 cases
摘要
Abstract
Objective This study was conducted to summarize clinical feature of elderly patients with drug-induced liver injury(DILI),and to investigate risk factors impacting severity of liver illness.Methods 181 elderly patients with various underlying diseases were encountered in our hospital between December 2018 and February 2024,and DILI was routinely diagnosed,catalogued and liver injury determined.Univariate and multivariate Logistic regression analysis was applied to find risk factors for liver injuries.Results Of 181 elderly patients,DILI was diagnosed in 44 cases(24.3%),including hepatocellular injury in 28 cases,cholestasis in 12 cases and mixed type in 4 cases;there were mild liver injury in 25 cases,moderate in 10 cases,severe in8 cases and dead in1 cases;suspected herbal medicines accounted for 27.3%,health care agents for 22.7%,agents for endocrine diseases for 13.6%and medicines for cardiovascular diseases for 11.4%,etc;ages in patients with DILI was 72(66,76)yr,much greater than[67(65,69)yr,P<0.05]in patients without DILI,percentages of multiple concurrent underlying diseases,alcohol abuse,fatty liver and hyperlipidemia were 79.6%,27.3%,56.8%and 84.1%,all much higher than 11.7%,3.6%,12.4%and 8.7%(all P<0.05)in patients without DILI;ages in 9 patients with liver injury grade 3 or more was73(67,75)yr,much older than[67(66,70)yr,P<0.05]in 35 patients with liver injury of grade 2 or less,percentages of ethanol intake,multiple underlying diseases and concurrent fatty liver was 88.9%,100.0%and 88.9%,all significantly greater than 11.4%,74.3%and 48.6%(all P<0.05)in patients with grade 2 or less liver injuries;multivariate Logisticregressionanalysisshowedthatelderly[OR:1.67,95%CI:1.26-3.05],alcohol abuse[OR:2.43,95%CI:1.35-3.17]and fatty liver[OR:2.14,95%CI:1.50-4.75]were all the risk factors impacting severity of liver injuries in elderly patients with DILI(P<0.05).Conclusion Herbal medicine,health care drugs,agents for endocrine and cardiovascular diseases could lead to DILI occurrence in elderly patients with multiple system diseases,in which drug-drug interactions might involve in this setting,and clinicians should carefully deal with underlying diseases,and prescribe medicines as necessary as possible.关键词
药物性肝损伤/基础疾病/危险因素/特征/老年Key words
Drug-induced liver injury/Underlying diseases/Clinical feature/Risk factors/Elderly引用本文复制引用
李勇,张蕾,吴幸福..老年药物性肝损伤患者临床特征分析[J].实用肝脏病杂志,2024,27(4):547-550,4.基金项目
安徽省自然科学基金青年基金资助项目(编号:2208085QC98) （编号:2208085QC98）
