药物性肝炎检测自身免疫性抗体的临床价值研究
详细信息 查看官网全文
- 英文论文题名：Detection of autoimmune antibody for diagnosis of drug-induced liver injury
- 论文作者：陆人杰 ; 唐风雷 ; 朱珊梅 ; 郑中伟
- 英文论文作者：LU Ren-jie ; TANG Feng-lei ; ZHU Shan-mei ; ZHENG Zhong-wei ; Department of Pharmacy ; Third People's Hospital ; Department of Gastroenterology ; Third People's Hospital
- 年：2016
- 作者机构：常州市第三人民医院药事科;常州市第三人民医院消化内科;
- 论文关键词：药物性肝炎 ; 自身免疫性抗体 ; 阳性检出率 ; 临床分析
- 英文论文关键词：Drug-induced liver injury ; clinical feature ; risk factor ; pathogenesis
- 会议召开时间：2016-09-27
- 会议录名称：中国药学会第十三届青年药学科研成果交流会论文集
- 语种：中文
- 分类号：R575.1
- 学会代码：YYWS
- 会议名称：中国药学会第十三届青年药学科研成果交流会
- 会议地点：中国江西南昌
- 主办单位：中国药学会
- 学会名称：中国药学会
- 页数：4
- 文件大小：293k
- 原文格式：O
- 会议级别：全国
摘要
目的:探讨自身免疫性抗体(autoimmune ant ibody,AA)的检测对鉴别诊断药物性肝炎(drug-induced liver injury,DILI)的临床意义,分析不同DILI患者的AA阳性检出率的差异性。方法:收集诊断为DILI患者的年龄、性别、发病时间、AA、肝功能指标及肝损药物种类等临床资料,评价DILI患者的这些临床资料与AA阳性检出率的关系。结果:CHILD分级A级患者AA阳性检出率51.1%;B级AA阳性检出率62.9%;C级AA阳性检出率72.4%。随着CHILD评分的提高,DILI患者的AA阳性检出率逐渐升高,但结果无统计学差异(P=0.256)。中药引起DILI患者的AA阳性检出率56.8%;西药引起DI LI患者的AA阳性检出率5 3.5%,中药引起AA阳性检出率稍高于西药,结果也无统计学差异(P=0.473)。但是,用药时间≥30目的患者AA阳性检出率(68.9%)明显高于用药时间<30日的患者(39.9%),差异有统计学意义(P=0.000)。结论:DILI患者AA阳性检出率与性别、年龄分布、CHILD分级、临床分型以及肝损药物种类关系并不密切,但随着用药时间延长,患者AA阳性检出率可能提高,检测AA对于用药时间较长而出现肝功能异常的患者检测AA有一定参考意义。
Objective To explore the clinical significance of autoimmune antibody detection in the differential diagnosis of drug-induced liver injury(DILI),and to analysis the differences of autoantibody positive rate between different patients.Methods Data of patients with a first diagnosis of DILI were collected for systematic retrospective study.The Correlation between clinical characteristics,clinical classification,risk factors,laboratory indices,hepatotoxic drugs and autoantibody positive rate was analyzed.Results For patients with class A DILI,51.1%were autoantibody-positive;for patients with class B DILI,62.9%were autoantibody-positive;while for those with class C DILI,72.4%were autoantibody-positive.These results suggested that autoantibody positive rate rose gradually with elevating CHILD score,showing no significant differences(P=0.256).Among all patients with Chinese drug-induced DILI,56.8%were autoantibody-positive,while among all patients with Western drug-induced DILI,53.5%were autoantibody-positive.Chinese drug-induced DILI with positive rate of AA was slightly higher than Western drug-induced DILI,showing no significant difference(P=0.473).For > 30 days group,68.9%patients were autoantibody-positive,while for < 30 days group,39.9%patients were autoantibody-positive.These results revealed significantly higher autoantibody positive rate in the medication time > 30 days group than the medication time < 30 days group(P=0.000).Conclusions Detection of autoantibodies may have no significant referential value for differentiation among clinical types(gender,age,type of liver injury and CHILD classification,et al).For DILI patients,the longer the medication time,the higher the positive rate of autoantibodies.Detection of autoantibodies in patients with abnormal liver function as a result of prolonged medication has significant referential value.
Objective To explore the clinical significance of autoimmune antibody detection in the differential diagnosis of drug-induced liver injury(DILI),and to analysis the differences of autoantibody positive rate between different patients.Methods Data of patients with a first diagnosis of DILI were collected for systematic retrospective study.The Correlation between clinical characteristics,clinical classification,risk factors,laboratory indices,hepatotoxic drugs and autoantibody positive rate was analyzed.Results For patients with class A DILI,51.1%were autoantibody-positive;for patients with class B DILI,62.9%were autoantibody-positive;while for those with class C DILI,72.4%were autoantibody-positive.These results suggested that autoantibody positive rate rose gradually with elevating CHILD score,showing no significant differences(P=0.256).Among all patients with Chinese drug-induced DILI,56.8%were autoantibody-positive,while among all patients with Western drug-induced DILI,53.5%were autoantibody-positive.Chinese drug-induced DILI with positive rate of AA was slightly higher than Western drug-induced DILI,showing no significant difference(P=0.473).For > 30 days group,68.9%patients were autoantibody-positive,while for < 30 days group,39.9%patients were autoantibody-positive.These results revealed significantly higher autoantibody positive rate in the medication time > 30 days group than the medication time < 30 days group(P=0.000).Conclusions Detection of autoantibodies may have no significant referential value for differentiation among clinical types(gender,age,type of liver injury and CHILD classification,et al).For DILI patients,the longer the medication time,the higher the positive rate of autoantibodies.Detection of autoantibodies in patients with abnormal liver function as a result of prolonged medication has significant referential value.
引文
[1]Danan G,Benichou C.Causality assessment of adverse reactions to drugs-I.A novel method based on the conclusions of international consensus meetings:application to drug-induced liver injuries[J].J Clin Epidemiol,1993,46:1323-1330.
[2]刘士敬,李建宁.浅谈雷公藤制剂对肝脏的损害[J].中国中医药现代远程教育,2014,12:104-105.
[3]徐静,汪茂荣.土三七导致肝小静脉闭塞综合征研究进展[J].实用肝脏病杂志,2013,16:94-96.
[4]魏青,阿怀红.非典型性抗精神病药物对肝功能影响分析[J].中华临床医学研究杂志,2007,13:1301.
[5]梁德敏,吕美容.抗精神病药物对精神分裂症患者肝功能的影响[J].海南医学,2008,19:8-10.
[2]刘士敬,李建宁.浅谈雷公藤制剂对肝脏的损害[J].中国中医药现代远程教育,2014,12:104-105.
[3]徐静,汪茂荣.土三七导致肝小静脉闭塞综合征研究进展[J].实用肝脏病杂志,2013,16:94-96.
[4]魏青,阿怀红.非典型性抗精神病药物对肝功能影响分析[J].中华临床医学研究杂志,2007,13:1301.
[5]梁德敏,吕美容.抗精神病药物对精神分裂症患者肝功能的影响[J].海南医学,2008,19:8-10.