Management of drug-induced liver disease.
Management of drug-induced liver disease.
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DOI：
10.1007/s11894-001-0039-y
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发表时间：
2001-02-01
影响因子：
--
通讯作者：
Lewis, J H
中科院分区：
文献类型：
--
作者：
Marino, G;Zimmerman, H J;Lewis, J H
药物性肝损伤的治疗和预防应从及早认识肝毒性入手，以便尽快停用可疑药物。肝酶监测和对涉及肝脏的过敏迹象的警惕都是许多已知导致肝细胞坏死导致肝功能衰竭的有用的策略。只有少数药物存在预防或限制肝脏损伤的特定解毒剂，其中最重要的是用于治疗对乙酰氨基酚肝毒性的N-乙酰半胱氨酸。皮质类固醇在治疗暴发性衰竭方面有未经证实的益处。乌索地尔对胆汁淤积性损伤可能有帮助。对于其他药物，当药物损伤演变为不可逆转的肝功能衰竭时，可以采取支持性措施，增加肝脏辅助设备的使用，以及紧急肝移植。人们希望，对肝脏毒性机制的更好理解将在不久的将来导致更具体和有效的治疗形式的发展。
The treatment and prevention of drug-induced liver injury starts with the recognition of hepatotoxicity at the earliest possible time so that the suspected drug can be discontinued expeditiously. Both liver enzyme monitoring and vigilance for signs of hypersensitivity involving the liver are useful strategies for many agents known to cause hepatocellular necrosis leading to liver failure. Specific antidotes to prevent or limit hepatic damage exist for only a few drugs, the most important being N-acetylcysteine for the treatment of acetaminophen hepatotoxicity. Corticosteroids are of unproven benefit in the setting of fulminant failure. Ursodiol may be helpful in instances of cholestatic injury. For other agents, supportive measures and the increasing use of liver-assist devices as well as emergency liver transplantation are available when drug injury evolves into irreversible liver failure. It is hoped that a better understanding of hepatotoxicity mechanisms will lead to the development of more specific and effective forms of therapy in the near future.