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药物性肝损伤病理学的特征及鉴别诊断

杨永峰

杨永峰. 药物性肝损伤的病理特征和病理诊断[J]. 临床肝胆病杂志, 2021, 37(11): 2530-2533. DOI: 10.3969/j.issn.1001-5256.2021.11.005.
引用本文: 杨永峰. 药物性肝损伤的病理特征和病理诊断[J]. 临床肝胆病杂志, 2021, 37(11): 2530-2533. DOI: 10.3969/j.issn.1001-5256.2021.11.005.
YANG YF. Pathological features and pathological diagnosis of drug-induced liver injury[J]. J Clin Hepatol, 2021, 37(11): 2530-2533. DOI: 10.3969/j.issn.1001-5256.2021.11.005.
Citation: YANG YF. Pathological features and pathological diagnosis of drug-induced liver injury[J]. J Clin Hepatol, 2021, 37(11): 2530-2533. DOI: 10.3969/j.issn.1001-5256.2021.11.005.

药物性肝损伤病理学的特征及鉴别诊断

DOI: 10.3969/j.issn.1001-5256.2021.11.005
基金项目: 

国家自然科学基金面上项目 81970454

详细信息
    通信作者:

    杨永峰,yangyongfeng@njucm.edu.cn

  • 中图分类号: R575

Pathological features and pathological diagnosis of drug-induced liver injury

Research funding: 

General Project of National Natural Science Foundation of China 81970454

  • 摘要: 药物性肝损伤(DILI)肝组织学表现分为炎症坏死型、胆汁淤积型、脂肪变性和脂肪肝炎型、血管损伤型、轻微病变型等多种病理类型。对于疑诊为DILI但又不肯定、不能用DILI一元论解释的肝损伤、多药物接触史而不能确定具体致损药物的DILI、治疗效果不符合预期DILI、慢性DILI等,需要组织病理学进一步鉴别诊断;组织病理学还可用于评估DILI病情轻重和预后。因DILI肝组织病变分布不均一,要有充足的组织样本量才能减少取样误差。由于肝损伤性疾病组织病理学表现“一因多果、多因一果”,病理密切结合临床才能最大可能得出最终诊断,在DILI的组织学诊断过程中临床病理讨论尤为重要。

     

  • 图  1  疑诊DILI时的组织病理学鉴别路径[20]

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    俞海英, 郭银燕, 杨永峰. 阿莫西林导致胆管缺失型药物性肝损伤1例[J]. 肝脏, 2018, 23(12): 1155-1156. DOI: 10.14000/j.cnki.issn.1008-1704.2018.12.039.
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    刘红丽, 杨永峰, 熊清芳, 等. 470例行肝穿刺活组织检查的不明原因肝病的病因分析[J]. 中华肝脏病杂志, 2019, 27(11): 885-889. DOI: 10.3760/cma.j.issn.1007-3418.2019.11.012.
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    杨永峰. 提高肝病学科临床医师的病理修养[J]. 临床肝胆病杂志, 2018, 34(11): 2267-2270. DOI: 10.3969/j.issn.1001-5256.2018.11.001.
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出版历程
  • 收稿日期:  2021-09-15
  • 录用日期:  2021-09-15
  • 出版日期:  2021-11-20
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