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《中草药相关肝损伤临床诊疗指南》指导临床诊断的回顾性分析
Guiding significance of Guideline for diagnosis and treatment of herb-induced liver injury in clinical diagnosis: a retrospective analysis
文章发布日期:2016年09月28日  来源:  作者:朱 云,王睿林,孙雪英,等  点击次数:1244次  下载次数:376次

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【摘要】:摘要:目的探讨《中草药相关肝损伤临床诊疗指南》指导中草药相关肝损伤(HILI)诊断的临床意义。方法回顾性分析2009年1月-2014年1月解放军三○二医院收治的、按照美国胃肠病学会指南推荐的HILI诊断策略诊断为HILI的595例住院患者的临床资料。计数资料组间比较采用χ2检验。结果按照《中草药相关肝损伤临床诊疗指南》推荐的HILI诊断标准,595例(100%)诊断为疑似HILI,234例(39.3%)诊断为临床HILI,52例(8.7%)诊断为确定HILI。在临床HILI和确定HILI患者中,临床分型以肝细胞损伤型为主,分别占85.0%、94.2%;严重程度分级以重度为主,分别占52.6%、42.3%。疑似、临床、确定HILI患者的预后差异无统计学意义,均以治愈为主,分别占81.5%、82.5%、80.8%。结论《中草药相关肝损伤临床诊疗指南》可有效指导HILI诊断,避免临床误诊发生,为中草药的安全应用提供保障,其临床诊断指导价值有待更多前瞻性研究探讨。
【Abstract】:ObjectiveTo investigate the clinical guiding significance of Guideline for diagnosis and treatment of herb-induced liver injury in the diagnosis of herb-induced liver injury (HILI). MethodsA retrospective analysis was performed for the clinical data of 595 hospitalized patients who were admitted to 302 Hospital of PLA from January 2009 to January 2014 and diagnosed with HILI according to HILI diagnostic strategies recommended by American College of Gastroenterology. The chi-square test was used for comparison of categorical data between groups. ResultsAccording to the Guideline for diagnosis and treatment of HILI, all 595 patients (100%) were diagnosed with suspected HILI, 234 (39.3%) were diagnosed with clinical HILI, and 52(8.7%) were diagnosed with definite HILI. Among the patients with clinical and definite HILI, 85.0% and 94.2%, respectively, had a clinical type of cell injury, and 52.6% and 423%, respectively, had a severe disease. There were no significant differences in prognosis between the patients with suspected, clinical, and definite HILI, and 81.5%, 82.5%, and 80.8%, respectively, were cured. ConclusionGuideline for diagnosis and treatment of HILI can effectively guide the diagnosis of HILI, avoid misdiagnosis in clinical practice, and guarantee the safe application of Chinese herbal medicine. Its clinical guiding significance in the diagnosis of HILI awaits more prospective studies.
【关键字】:药物性肝损伤; 中草药; 回顾性研究
【Key words】:drug-induced liver injury; drugs, Chinese herbal; retrospective studies
【引证本文】:朱云, 王睿林, 孙雪英, 等. 《中草药相关肝损伤临床诊疗指南》指导临床诊断的回顾性分析[J]. 临床肝胆病杂志, 2016, 32(11): 2159-2162.

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