静脉滴注阿奇霉素致儿童药物性肝损伤的临床特征及影响因素分析

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中图分类号 R985；R978.1；R969.3 文献标志码A 文章编号 1001-0408（2025）20-2566-05

DOI10.6039/j.issn.1001-0408.2025.20.14

Analysisofclinical characteristicsand influential factorsof drug-induced liver injuryinchildrencaused by intravenousazithromycin

LI Wanhui'，LYU Xiaoqian’，SU Dan’，HUO Baofeng，CHEN Hejun²，YAN Ping1（1. Dept.of Pediatric Internal Medicine，Hengshui People’sHospital，Hebei Hengshui O530O0，China；2.Dept.of Pharmacy，Hengshui People'sHospital，Hebei Hengshui O53000，China）

ABSTRACTOBJECTIVEToanalyze theclinicalcharacteristicsand influential factorsof drug-inducedliver injury（DILI）in childrencausedbyintravenousazithromycin.METHODsClinical dataof157DILI pediatriccasescausedbyintravenous azithromycin，reportedbythe Hengshui AdverseDrugReactionMonitoring Centerfrom January2O15toJanuary2025，were collctedastheobservationgroup.Clinical dataof pediatricpatients whoreceivedintravenous azithromycinbutdidnotdevelop DILIduringthesameperiodatHengshuiPeople’sHospitalwerecolectedina1：1ratiotoserveasthecontrolgroup.Theclinical clasification，severityandprognosisofDILIinpediatricpatientsfromtheobservationgroupwereanalyzedUnivariateand multivariateLogisticregressonanalyseswereusedtosreetheindependentrisfactorsforDIIinchildrencausedbyintravenous azithromycin. RESULTS Among 157 DILI cases，92 cases（ 58.60% ）had hepatocellular injury-type，51 cases（ 32.48% ）had cholestatic-type，and 14 cases （ 8.92% ）had mixed-type.DILI severitywas grade1in117 cases（ 74.52% ），grade2in 33cases （20 （21.02% ），andgrade3in7cases（ 4.46% ）.Liver function had all recovered after stopping medication and symptomatic treatment. Combined with acetaminophen [OR =3.769 ， 95%CI （1.615，8.235）， P=0.021] ，daily dose of azithromycin >10mg/kg [OR 2.237， 95%CI （1.075，4.655）， P=0.034. were independent risk factors for DILI in children caused by intravenous azithromycin. CONCLUSIONS Hepatocelularijury-typeandcholestatic-typearerelativelycommon inchildren withDLIcausedbyintravenous azithromycin，with mild severity being predominantand showingafavorable prognosis.Combination withacetaminophenanddaily

do se>10mg/kg areindependent risk factors for azithromycininduced DILI in children.

KEYWORDSazithromycin；drug-induced liver injury；children; clinicalcharacteristics；influential factors

阿奇霉素是临床应用广泛的大环内酯类抗菌药物，是治疗非典型病原体、细菌感染的常用药物之一。（剩余8566字）