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药物性肝损伤的发病机制及其处理
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- Author:
- No author available
- Journal Title:
- Chinese Journal of Tuberculosis and Respiratory Diseases
- Issue:
- 10
- DOI:
- 10.3760/cma.j.issn.1001-0939.2013.10.004
- Key Word:
- No keyword available
Abstract： 抗结核药物的不良反应主要有药物性肝损伤(druginduced liver injury,DILI)、周围神经炎、消化道反应和皮疹等,其中以DILI最常见,也最为严重,是导致治疗中断、更改方案、疗效降低和耐药的根本原因.尽管DILI的一般预后较好,部分患者仅出现无症状氨基转移酶升高,但严重DILI可致急性肝功能衰竭,病死率约为0.4％ ～ 1.5％,占肝功能衰竭病死率的5.7％[1].抗结核药所致DILI的发病率约为2％～28％ [2-4],由于种族、地理环境及诊断标准不同,其实际发生率尚难确定.异烟肼、利福平和吡嗪酰胺均有较强的肝脏毒性,联合应用可增加肝损伤的风险[5].
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