由直接口服抗凝剂引起的肝损伤
Deven Juneja1, Prashant Nasa2,3, Ravi Jain4
1Institute of Critical Care Medicine, Max Super Specialty Hospital, New Delhi 110017, India.
World journal of hepatology
|July 3, 2023
概括
药物诱导性肝损伤 (DILI) 由于直接作用的口服抗凝剂 (DOAC) 是罕见但严重的. 虽然大多数患者在停止服用药物后会康复,但需要进一步的研究来确定风险因素.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 药理学 药理学是指药理学的学科.
- 内部医学 内部医学
背景情况:
- 药物诱导性肝损伤 (DILI) 是药物安全的一个重大问题.
- 直接作用的口服抗凝剂 (DOAC) 越来越多地被处方,需要了解它们的安全性.
- 以前的元分析表明,DOACs不会增加DILI风险,但个别风险因素仍然不清楚.
研究的目的:
- 在使用DOACs的患者中确定DILI的风险因素和结果.
- 系统地审查和元总结最近的案例报告和DOAC诱导的DILI系列.
主要方法:
- 在PubMed,Science Direct,参考引用分析和谷歌学者中进行系统的文献搜索.
- 包括在成人患者中对DOACs次要的DILI的病例报告和病例系列.
- 提取有关患者人口统计,并发症,药物,实验室结果,成像,组织学,管理和结果的数据.
主要成果:
- 分析了15项涉及27名DOAC诱导的DILI患者的研究.
- 里瓦罗克萨班是最常见的致病因子 (74.1%).
- 常见的症状包括黄 (55.6%),不适 (33.3%) 和吐 (33.3%);肝脏活检显示急性肝炎和胆固醇损伤. 大多数患者康复了,但有一例死亡.
结论:
- 对DOACs次要的DILI是一种罕见但潜在的严重并发症.
- 早期戒毒对于管理DOAC诱导的DILI至关重要.
- 虽然结果通常是有利的,但进一步的研究,包括基于人口的研究,对于了解发病率和风险因素至关重要.
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