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药源性肝损害是指由药物直接或间接损害肝细胞而引起的肝功能损害。近年来,由于各种药物广泛应用,各种新药特药不断应用于临床,尤其是多种药物合用,使药源性肝损害发生率明显增高,日渐引起各界的重视。1 引起肝脏损害的药物1.1 抗生素及抗结核药 本类药物可以引起肝细胞损害。土霉素可致肝肿大、黄疸、脂肪肝等。四环素可造成妊娠期妇女严重肝损害甚至死亡。无味红霉素可引起肝细胞变性和坏死,胆汁郁积的发生率为2％～4％。氯霉素对早产儿和新生儿毒性大,可引起SGPT升高及肝损害。利福平即可以造成肝细胞变性坏死,又可以造成肝汁郁积,在抗结核治疗时,常将其与异烟肼合用以增强疗效,但两者合用毒性高达35％。因为利福平是肝药酶诱导剂,与异烟肼合用,使异烟肼的肝毒性代谢产物乙酰肼增多,因而加重肝损害。
Drug-induced liver damage refers to the liver damage caused by drugs directly or indirectly damaged liver cells. In recent years, due to the wide application of various drugs, various new drugs continue to be used clinically, especially the combination of a variety of drugs, so that the incidence of drug-induced liver damage was significantly increased, attracting increasing attention from all walks of life. 1 cause liver damage drugs 1.1 Antibiotics and anti-TB drugs These drugs can cause liver cell damage. Oxytetracycline can cause liver enlargement, jaundice, fatty liver and so on. Tetracycline can cause severe liver damage in pregnant women and even death. Erythromycin can cause degeneration and necrosis of liver cells, the incidence of cholestasis 2% to 4%. Chloramphenicol in premature children and neonatal toxicity, can cause SGPT increased liver damage. Rifampicin can cause liver cell degeneration and necrosis, but also can cause liver stasis, in the anti-TB treatment, often combined with isoniazid to enhance the efficacy, but the combined toxicity of both up to 35%. Because rifampicin is a hepatic drug inducer, combined with isoniazid, so that the isoniazid hepatotoxic metabolite acetohydrazide increased, thus increasing liver damage.