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肝损伤药物目录及合理用药专家共识
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| 篇名： | 肝损伤药物目录及合理用药专家共识 |
| TITLE： | Expert consensus on the medication catalog for drug-induced liver injury and rational drug use |
| 摘要： | 目的 系统性梳理导致药物性肝损伤（DILI）的药物及其相关信息，制定《肝损伤药物目录及合理用药专家共识》（下文简称《共识》），为临床合理用药提供参考。方法系统检索各文献数据库、指南检索网站和肝损伤专业网站等，提取所纳入文献和网站资源中导致DILI的药物并根据来源赋值——LiverToxA类药物计3分、B类药物计2分；Hepatox、指南来源药物各计2分；共识和综述来源药物各计1分。纳入LiverToxA、B类及其余来源中总得分≥4分的药物形成导致DILI的药物初始目录。通过3轮德尔菲法（包括问卷调查和讨论会）收集并整合由全国27个省份的45名医学、药学专家组成的多学科专家组的意见，修订后形成《共识》终稿。结果与结论本《共识》共纳入何首乌、麻黄等12种中药，胺碘酮、阿托伐他汀等151种西药及其合理用药信息。其中，中药的合理用药信息包括循证得分、基于发病机制的肝损伤分型、基于生物化学异常模式的肝损伤分型、临床表型、实验室检查表现、潜伏期、消退时间、应对措施8项；西药的合理用药信息在此基础上增加了肝功能监测、停药、禁忌、慎用、剂量调整、危险因素6项，共计14项。本《共识》对导致DILI的药物及其合理用药信息进行了系统性梳理，有助于增强临床对DILI的预防、识别和处理能力，降低肝损伤发生率，确保患者用药安全、有效。 |
| ABSTRACT： | OBJECTIVE To systematically sort out the drugs causing drug-induced liver injury （DILI） and their relevant information， and to develop the Expert consensus on the medication catalog for drug-induced liver injury and rational drug use （hereinafter referred to as the Consensus）， so as to provide a reference for rational clinical use. METHODS Systematic searches were conducted across various literature databases， guideline retrieval websites and professional liver injury websites. Drugs identified as causing DILI from the included literature and online resources were extracted and assigned scores based on source credibility： three points for LiverTox A-class drugs and two points for B-class drugs； two points for drugs from Hepatox and guidelines； and one point for drugs from consensus and related literature sources. Drugs classified as LiverTox category A/B or with total scores ≥4 were included in the preliminary list of DILI-causing drugs. Opinions were collected and integrated from a multidisciplinary expert panel comprising 45 medical and pharmaceutical experts from 27 provinces across China through three rounds of the Delphi method （including questionnaires and discussion sessions）， and after revision， the final version of Consensus was formed. RESULTS & CONCLUSIONS This Consensus included 12 traditional Chinese medicines （TCMs） such as Polygoni Multiflori Radix and Ephedrae Herba， 151 Western medicines including amiodarone and atorvastatin， along with rational use information. For TCM， eight rational use information were included： evidence-based score， liver injury classification based on pathogenesis， liver injury classification based on biochemical abnormality pattern， clinical phenotype， laboratory examination manifestations， latency period， recovery time， and management strategies. For Western medicines， six additional items were included based on the TCM， namely liver function monitoring， discontinuation， contraindications， cautions， dose adjustments， and risk factors， totaling 14 items. This Consensus systematically compiles DILI drugs and their rational use information， which will support clinicians in enhancing the prevention， identification， and management of DILI， reducing the incidence of liver injury， and ensuring patient medication safety and efficacy. |
| 期刊： | 2026年第37卷第03期 |
| 作者： | 李健春；陈頔；金鹏飞；国家老年医学中心；中国医药教育协会老年药学专业委员会；中国老年保健医学研究会药事管理与药学创新分会；中国老年医学学会药事管理与药学服务分会；北京药学会老年药学专业委员会 |
| AUTHORS： | LI Jianchun， CHEN Di，JIN Pengfei，National Center of Gerontology，Geriatric Pharmacy Professional Committee of the China Medicine Education Association，Pharmacy Management and Pharmaceutical Innovation Branch of the Chinese Association of Geriatric Resear |
| 关键字： | 肝损伤；合理用药；医院药学；专家共识 |
| KEYWORDS： | liver injury； rational drug use； hospital pharmacy； expert consensus |
| 阅读数： | 3 次 |
| 本月下载数： | 0 次 |
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