药物性肝损伤的研究进展及我国存在的问题

陈成伟

doi:10.3969/j.issn.1001-5256.2018.06.001

药物性肝损伤的研究进展及我国存在的问题

DOI: 10.3969/j.issn.1001-5256.2018.06.001

陈成伟

上海南京军区临床肝病研究中心

详细信息

中图分类号: R575
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- 被引次数: 0
出版历程
- 收稿日期: 2018-03-31
- 出版日期: 2018-06-20

Research advances in drug-induced liver injury and existing problems in China

Chen ChengWei

Shanghai Liver Disease Research Center of Nanjing Military Area

摘要

摘要: 目前,药物性肝损伤(DILI)已成为临床最常见急性肝损伤的原因。从DILI的发病机制、新的生物标志物、肝脏对药物毒性的耐受、适应与易感性、ALT诊断阈值等方面进行了阐述,提醒应了解诊断量表发展史,以统一标准和认识,要重视草药和膳食补充剂引起的DILI,并深入研究其导致DILI的发病机制,从而预防或减少DILI的发生。我国DILI研究存在的问题和差距是明显的,基础研究相当匮乏,在临床方面也有很多空白,因此,我们要努力跟上国际研究的步伐,使药物更好地为人类服务。
- 药物性肝损伤 /
- 述评
Abstract: At present, Drug-induced liver injury (DILI) has become the most common cause of acute liver injury in clinical practice. This article elaborates on the pathogenesis of DILI, new biomarkers, liver tolerance to drug toxicity, adaptability and susceptibility, and testing threshold of alanine aminotransferase. Meanwhile, we should understand the development history of diagnostic scale, develop unified standards and understanding, and attach importance to DILI induced by medicinal herbs and dietary supplements, and in-depth studies on the pathogenesis of DILI should be performed to prevent or reduce DILI. There are several problems in DILI studies in China and obvious gaps between China and foreign countries, with a lack of basic research and blanks in clinical aspects. Therefore, we must strive to keep up with international research so that drugs can better serve the human.
- drug-induced liver injury /
- editorial

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参考文献(18)

[1] CHALASANI NP, HAYASHI PH, BONKOVSKY HL, et al.ACG clinical guideline:the diagnosis and management of idiosyncratic drug-induced liver injury[J].Am J Gastroenterol, 2014, 109 (7) :950-966.

[2]GOLDRING C, ANTOINE DJ, BONNER F, et al.Stem cell-derived models to improve mechanistic understanding and prediction of human drug-induced liver injury[J].Hepatology, 2017, 65 (2) :710-721.

[3]HUNT CM, PAPAY JI, STANULOVIC V, et al.Drug rechallenge following drug-induced liver injury[J].Hepatology, 2017, 66 (2) :646-654.

[4]AITHAL GP, WATKINS PB, ANDRADE RJ.Case definition and phenotype standardization in drug-induced liver injury[J].Clin Pharmacol Ther, 2011, 89 (6) :806-815.

[5]YU YC, FAN Y, CHEN CW.Criteria for the chronicity of druginduced liver injury:3 or 6 months or 1 year[J].Chin Hepatol, 2017, 22 (2) :97-99. (in Chinese) 于乐成, 范晔, 陈成伟.药物性肝损伤慢性化判断标准:3或6个月还是1年[J].肝脏, 2017, 22 (2) :97-99.

[6]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 (11) :1323-1330.

[7]DANAN G, TESCHKE R.RUCAM in drug and herb induced liver injury:The update[J].Int J Mol Sci, 2015, 17 (1) :14.

[8]HAYASHI PH.Causality assessment in drug-induced liver injury[J].Semin Liver Dis, 2009, 29 (4) :348-356.

[9]The Study of Drug Induced Liver Disease of Chinese.Guidelines for the management of drug-induced liver injury[J].Chin Hepatol, 2015, 20 (10) :750-767. (in Chinese) 中华医学会肝病学分会药物性肝病学组.药物性肝损伤诊治指南[J].肝脏, 2015, 20 (10) :750-767.

[10]YU YC, MAO YM, CHEN CW, et al.CSH Guideline for the diagnosis and treatment of drug-induced liver injury[J].Hepatol Int, 2017, 11 (3) :221-241.

[11]FORD R, SCHWARTZ L, DANCEY J, et al.US Food and Drug Administration.Center for Drug Evaluation and Research (CDER) , Center for Biologics Evaluation and Research (CBER) .Guidance for industry:Drug-induced liver injury——premarketing clinical evaluation[J].Eur J Cancer, 2009, 45 (2) :268-274.

[12]MAO YM, LIU XL, CHEN CW.An introduction of the guidelines for drug-induced liver injury by the U.S.Food and Drug Administration in 2013[J].Chin Hepatol, 2013, 18 (5) :325-330. (in Chinese) 茅益民, 刘晓林, 陈成伟.2013年美国FDA药物性肝损伤指南介绍[J].肝脏, 2013, 18 (5) :325-330.

[13]NAVARRO VJ, KHAN I, BJRNSSON E, et al.Liver injury from herbal and dietary supplements[J].Hepatology, 2017, 65 (1) :363-373.

[14]BJRNSSON ES, BERGMANN OM, BJRNSSON HK, et al.Incidence, presentation, and outcomes in patients with drug-induced liver injury in the general population of Iceland[J].Gastroenterology, 2013, 144 (7) :1419-1425.

[15]LI L, JIANG W, WANG JY, et al.Clinical analysis of acute drug-induced liver disease in 275 cases[J].J Clin Hepatol, 2009, 25 (1) :44-46. (in Chinese) 李蕾, 蒋炜, 王吉耀, 等.275例急性药物性肝病临床分析[J].临床肝胆病杂志, 2009, 25 (1) :44-46.

[16]ZHOU Y, YANG L, LIAO Z, et al.Epidemiology of drug-induced liver injury in China:A systematic analysis of the Chinese literature including 21, 789 patients[J].Eur J Gastroenterol Hepatol, 2013, 25 (7) :825-829.

[17]WATANABE I, TOMITA A, SHIMIZU M, et al.A study to survey susceptible genetic factors responsible for troglitazone-associated hepatotoxicity in Japanese patients with type 2 diabetes mellitus[J].Clin Pharmacol Ther, 2003, 73 (5) :435-455.

[18]WANG XJ, CHEN CW, FU QC, et al.Group-occurring liver injury induced by Zhixue capsules alone:An analysis of 30 cases[J].Chin Hepatol, 2009, 14 (4) :289-290. (in Chinese)

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