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中草药相关肝损伤的诊断： 实践中的挑战
DOI: 10.12449/JCH240805
利益冲突声明：本文不存在任何利益冲突。
作者贡献声明：董一诺、支阳负责数据采集，资料分析，文章起草工作，对本文贡献相同；唐洁婷、茅益民负责书写指导，文章审核和最终修改。
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摘要: 随着草药和膳食补充剂（HDS）在全球范围内的应用日益广泛，中草药相关肝损伤（HILI）已成为药物性肝损伤的重要病因。由于HILI表现多样、病史采集困难、缺乏特异性生物标志物等原因，如何及时发现疑似患者并建立正确诊断成为实践过程中的主要难题。目前诊断HILI的过程中多用到因果关系评估，但缺乏大样本前瞻性队列验证。此外，对于HILI诊断的特异性生物标志物仍有待进一步研究。HILI的诊断和鉴别诊断是极具挑战性的问题，目前尚无公认的统一、标准的方法适用于全因HILI的诊断。
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关键词:
- 中草药 /
- 化学性与药物性肝损伤 /
- 诊断 /
- 因果关系评估 /
- 生物标志
Abstract: With the increasingly wide application of herbal medicines and dietary supplements worldwide， herb-induced liver injury （HILI） has become an important etiology of drug-induced liver injury. Due to the diverse manifestations of HILI， the difficulty in medical history collection， and the lack of specific biomarkers， how to identify suspected patients and make a correct diagnosis has become a major challenge in practice. Causality assessment is commonly used in the diagnosis of HILI， but there is still a lack of prospective cohort studies with a large sample size. In addition， further studies are needed to search for the specific biomarkers for the diagnosis of HILI. The diagnosis and differential diagnosis of HILI are challenging， and currently there is still no universally accepted uniform and standard method for the diagnosis of all-cause HILI. -
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