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抗甲状腺药物所致肝损伤的诊断与治疗原则

杨睿涛 杨锐 邓勋 曾森祥 杨晓燕

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抗甲状腺药物所致肝损伤的诊断与治疗原则

DOI: 10.12449/JCH240331
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:杨锐、杨睿涛负责课题设计,资料分析,撰写论文;邓勋、曾森祥、杨晓燕参与收集数据,修改论文;杨锐负责拟定写作思路,指导撰写文章并最后定稿。
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    通信作者:

    杨锐, yangrui91@163.com (ORCID: 0000-0002-3066-7709)

Diagnosis and treatment principles of liver injury induced by antithyroid drugs

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    Corresponding author: YANG Rui, yangrui91@163.com (ORCID: 0000-0002-3066-7709)
  • 摘要: 药物治疗是甲状腺功能亢进的主要治疗方法。抗甲状腺药物可引起肝损伤,药物性肝损伤的诊断多采用排他性诊断,诊断基于病史采集、临床症状、血清生化、影像学及组织学等。药物性肝损伤可依据肝损伤严重程度分为轻度、中度、重度和致命四种等级,轻者常不必停药,但需定期监测肝功能,重者可发生肝衰竭,病死率高,若能尽早发现、及时停药,辅以合理药物治疗,可避免致命后果。抗甲状腺药物性肝损伤的治疗原则是促进肝损伤恢复、防止肝损伤重症化、慢性化和降低死亡风险。规范用药、及时监测、早期发现和早期治疗是防治抗甲状腺药物肝损伤的重要举措。

     

  • 图  1  ATD肝损伤诊断和鉴别诊断流程

    注: 在《中国药物性肝损伤诊治指南(2023年版)》[ 4]中“DILI的诊断和鉴别诊断流程图”基础上补充修订。

    Figure  1.  The procedure of ATD liver damage diagnosis and differential diagnosiss

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  • 收稿日期:  2023-08-08
  • 录用日期:  2023-09-05
  • 出版日期:  2024-03-20
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