Association between physical restraint and drug-induced liver injury
Association between physical restraint and drug-induced liver injury
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DOI：
10.1159/000119736
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发表时间：
2007-01-01
影响因子：
3.2
通讯作者：
Arai, Heii
中科院分区：
文献类型：
--
作者：
Hatta, Kotaro;Shibata, Nobuto;Arai, Heii
目的：由于动物模型表明束缚应激会增强外源性肝毒性，因此开展了一项病例对照研究，以调查精神科重症监护病房中身体束缚对药物性肝损伤（DILI）发展的影响。方法：比较 2003 年 1 月至 2006 年 12 月 4 年间入住精神科重症监护病房的受约束患者 (n = 106) 和不受约束患者 (n = 528) 的人口统计学和临床特征。结果：受约束患者 (8.5%) 和不受约束患者 (1.9%；优势比 4.81，p = 0.0016），尽管在医学和 精神状况。未发现药物平均数量存在差异。受约束组中接受抗精神病药物治疗的患者比例高于非受约束组，而非受约束组中接受抗抑郁药物治疗的患者比例高于受约束组。结论：尽管回顾性设计存在方法学限制，但可以保守地说，身体约束可能会带来 DILI 的风险。这一观察结果值得在前瞻性研究中得到证实。版权所有 (c) 2008 S. Karger AG，巴塞尔。
Objective: As animal models have suggested enhancement of xenobiotic-induced hepatotoxicity due to restraint stress, a case-control study was undertaken to investigate the effects of physical restraint on the development of drug-induced liver injury (DILI) in a psychiatric intensive care unit. Method: Demographic and clinical characteristics were compared between restrained patients (n = 106) and nonrestrained patients ( n = 528) admitted to the psychiatric intensive care unit during a 4-year period from January 2003 to December 2006. Results: Rates of DILI differed significantly between restrained patients (8.5%) and nonrestrained patients (1.9%; odds ratio 4.81, p = 0.0016), although no initial differences were seen in medical and psychiatric conditions. No differences in mean number of drugs were identified. The rate of patients who received antipsychotics was higher in the restrained group than in the nonrestrained group, whereas the rate of patients who received antidepressants was higher in the nonrestrained group than in the restrained group. Conclusions: Despite methodological limitations imposed by the retrospective design, a conservative claim can be made that physical restraint might represent a risk for DILI. This observation deserves confirmation in a prospective study. Copyright (c) 2008 S. Karger AG, Basel.