Drug-induced liver disease: an 8-year study of patients from one gastroenterological department

作者：Wang, Yi Ping; Shi, Bin; Chen, Yue Xiang; Xu, Jing; Jiang, Cai Feng; Xie, Wei Fen^*

来源：Journal of Digestive Diseases, 2009, 10(3): 195-200.

DOI：10.1111/j.1751-2980.2009.00385.x

• Chinese medicinal herb
• drug
• liver damage

OBJECTIVE:
To analyze drug-induced liver disease over an 8-year period from January 2000 to December 2007 in one gastroenterological department.
METHODS:
International consensus of standard definitions and criteria for assessing causality of adverse drug reactions were applied to all patients with abnormal hepatic test results.
RESULTS:
Drugs were implicated in hepatic injury in 30 patients (15 men and 15 women) in whom there was a causal or highly probable relationship between drug use and liver disease. The drugs responsible for liver damage were Chinese medicinal herbs (n = 12), cyclosporin (n = 2), fosfomycin, gentamicin, flutamide, acipimox and nimesulide (n = 1 each). Of the 30 patients, 19 (63.3%) were classified as having hepatocellular or mixed hepatitis, eight (26.7%) as having cholestatic injury and the remaining three as having a severe hepatic drug reaction (prothrombin < 50%), including death.
CONCLUSION:
A thorough history of medication should be taken in all patients presenting with abnormal hepatic test results. Chinese medicinal herbs were the most frequent hepatotoxic factor in our patients, although the liver injury was not severe in most cases and was relieved after the prompt withdrawal of the suspected drug.

• 出版日期2009-8
• 单位中国人民解放军第二军医大学; 天津市中医药研究院附属医院