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药物相关胆管消失综合征的研究进展

许姗姗 仇丽霞 宋静静 张晶

许姗姗, 仇丽霞, 宋静静, 等. 药物相关胆管消失综合征的研究进展[J]. 临床肝胆病杂志, 2021, 37(8): 1979-1982. DOI: 10.3969/j.issn.1001-5256.2021.08.051
引用本文: 许姗姗, 仇丽霞, 宋静静, 等. 药物相关胆管消失综合征的研究进展[J]. 临床肝胆病杂志, 2021, 37(8): 1979-1982. DOI: 10.3969/j.issn.1001-5256.2021.08.051
XU SS, QIU LX, SONG JJ, et al. Research advances in drug-induced vanishing bile duct syndrome[J]. J Clin Hepatol, 2021, 37(8): 1979-1982 DOI: 10.3969/j.issn.1001-5256.2021.08.051
Citation: XU SS, QIU LX, SONG JJ, et al. Research advances in drug-induced vanishing bile duct syndrome[J]. J Clin Hepatol, 2021, 37(8): 1979-1982 DOI: 10.3969/j.issn.1001-5256.2021.08.051

药物相关胆管消失综合征的研究进展

DOI: 10.3969/j.issn.1001-5256.2021.08.051
基金项目: 

佑安肝病艾滋病基金科研课题 YNKTTS20180115

详细信息
    通讯作者:

    张晶,drzhangjing@163.com

  • 中图分类号: R575.7

Research advances in drug-induced vanishing bile duct syndrome

Funds: 

The Scientific Research Project of YouAn Liver Disease AIDS Fund YNKTTS20180115

  • 摘要: 据目前研究表明,药物性肝损伤已成为临床急性肝损伤的常见原因之一。胆管消失综合征(VBDS)是指肝内胆管局灶性或弥漫性消失,临床表现以胆汁淤积为特点的综合征,药物相关胆管消失综合征(D-VBDS)是其重要病因之一。多数D-VBDS患者预后较好,但部分患者可进展为肝硬化、肝衰竭。通过回顾分析D-VBDS的临床诊疗进展,认为D-VBDS诊断困难、治疗方法有限、部分患者预后较差,临床上需谨慎应用药物以减少其发病率和病死率。

     

  • 表  1  导致VBDS的药物

    药物分类 具体药物
    抗感染药 替莫唑胺[5-6]、美罗培南[7-8]、甲氧苄啶-磺胺甲恶唑[4, 9-11]、阿莫西林[1, 6, 12]、阿莫西林-克拉维酸钾[1, 4]、阿奇霉素[1, 3]、氨苄青霉素[4]、复方新诺明[4]、克林霉素[1, 4]、头孢氨苄[4]、头孢唑林[4]、红霉素[1, 4]、氟喹诺酮[4, 13]、莫西沙星[14]、四环素[4]、阿托伐醌/氯胍[15]联合用药:头孢菌素+甲硝唑+克霉唑[16]
    非甾体消炎药 布洛芬[1, 4, 17-19]、对乙酰氨基酚[1]、洛索洛芬[20]
    抗精神药 丙戊酸[21]、卡马西平[1, 4]、阿米替林[4]、丙米嗪[4]、安定[4]、拉莫三嗪[1, 22]、舍曲林[23-24]
    降糖药 阿托伐他汀[1]、非诺贝特[1]
    降脂药 格列本脲[4]
    质子泵抑制剂[25] 奥美拉唑[1]
    中草药(包括中药和中成药)[25-26] 治疗骨关节病、风湿性关节炎、椎间盘膨出、镇静安神、皮肤病的中药[27]
    抗肿瘤药 英夫利昔单抗[28]联合用药:培西达替尼和紫杉醇[29]
    其他 西咪替丁[4]、硫唑嘌呤[4]、胃复安[1]联合药物:阿奇霉素+布洛芬+中成药物[30]
    下载: 导出CSV
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    [25] GENG WJ, LIU H, FAN CL, et al. Clinical features and prognosis of drug-induced vanishing bile duct syndrome[J]. J Capit Med Univ, 2018, 39(5): 675-679. DOI: 10.3969/j.issn.1006-7795.2018.05.010.

    耿文静, 刘晖, 范春蕾, 等. 药物性肝内胆管消失综合征的临床特征与转归[J]. 首都医科大学学报, 2018, 39(5): 675-679. DOI: 10.3969/j.issn.1006-7795.2018.05.010.
    [26] LI L, ZHANG GQ, LIAO Z, et al. Experience of 34 cases of vanishing bile duct syndrome a single center[J]. Chin J Gastroenterol Hepatol, 2014, 23(9): 1104-1106, 1110. DOI: 10.3969/j.issn.1006-5709.2014.09.037.

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  • 收稿日期:  2020-12-21
  • 修回日期:  2021-01-19
  • 刊出日期:  2021-08-16
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