Drug-induced liver injury in a Swedish University hospital out-patient hepatology clinic
Drug-induced liver injury in a Swedish University hospital out-patient hepatology clinic
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DOI：
10.1111/j.1365-2036.2006.03117.x
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发表时间：
2006-10-15
影响因子：
7.6
通讯作者：
Bjornsson, E.
中科院分区：
文献类型：
--
作者：
De Valle, M. B.;Klinteberg, V. Av;Bjornsson, E.
背景：目前关于肝内科门诊患者中药物性肝损伤比例的数据有限。目的确定药物性肝损伤病例的比例，明确最主要的药物及肝损伤的性质。方法对1995-2005年瑞典大学附属医院肝病门诊计算机诊断数据库进行分析。所有疑似药物性肝损伤病例均采用国际共识标准进行因果关系评估。结果同期首次发现病例1164例。药物性肝损伤77例（6.6%）存在至少可能的因果关系，其中38例（3.3%）因药物性肝损伤住院后接受门诊评估，3%住院后接受随访。中位年龄为58岁，43例（56%）为女性，肝细胞型37例（48%），胆汁淤积型31例（40%），混合型12%。抗生素是引起药物性肝损伤最常见的药物，其次是非甾体类抗炎药，双氯芬酸最常引起药物性肝损伤。结论药物性肝损伤占门诊病例的6%，占转诊病例的3%，且以女性居多。抗生素和双氯芬酸是门诊患者药物性肝损伤最常见的原因。
BackgroundLimited data exist on the proportion of drug-induced liver injury among out-patients seen in a hepatology clinic.AimTo determine the proportion of drug-induced liver injury cases, and identify the most important agents and the nature of the liver injury.MethodsA computerized diagnoses database in an out-patient hepatology clinic in a Swedish University hospital was analysed during the period 1995-2005. All suspected drug-induced liver injury cases were causality assessed with the International Consensus Criteria.ResultsA total of 1164 cases were seen for the first time during this period. Drug-induced liver injury with at least a possible causal relationship was found in 77 cases (6.6%), 38 (3.3%) of whom were referred for evaluation to the out-patient clinic whereas 3% had a follow-up after hospitalization of drug-induced liver injury. The median age was 58 years, 43 (56%) were females, a hepatocellular pattern was observed in 37 cases (48%), cholestatic in 31 (40%) and mixed in 12%. Antibiotics were the most common agents causing drug-induced liver injury followed by non-steroidal anti-inflammatory drugs, with diclofenac most often responsible for the drug-induced liver injury.ConclusionsDrug-induced liver injury cases constituted 6% of all out-patients and 3% of referrals and occurred more often in women. Antibiotics and diclofenac were the most common causes of drug-induced liver injury among out-patients.