药肝所致肝窦阻塞综合征研究进展 作者：卢俊竹 詹俊来源：《新医学》第 12 期 【摘要】由药品所致的肝窦阻塞综合征是药品性肝损伤的一种临床类型，临床体现以肝区疼痛、肝肿大、黄疸以及腹腔积液为重要特性，需与布加综合征、淤血性肝病等相鉴别。现在该病发病机制尚未完全阐明，缺少特效治疗手段，去纤苷疗效相对较为必定。在我国，该病的报道不多，重要因服用土三七等含吡咯烷生物碱的中草药引发，极易被漏诊、误治。该文对肝窦阻塞综合征展开综述，介绍其最新研究进展，以期进一步提高临床上对该病的认识和诊治水平。 【核心词】药品性肝损伤；肝窦阻塞综合征；吡咯烷生物碱；去纤苷 【Abstract】Sinusoidal obstruction syndrome （SOS ） caused by drugs is a clinical type of drug-induced liver injury The clinical manifestations of SOS mainly include liver pain ，hepatomegaly ， jaundice and peritoneal effusion It should be differentially diagnosed from Budd-Chiari syndrome and congestive hepatopathy At present ， the pathogenesis of SOS remains elusive and effective treatment is lacking Usage of defibrotide has been proven to yield relatively positive outcomes In China ， few cases of SOS have been reported A majority of patients with SOS are caused by intake of tusanqi and other Chinese herbal medicines containing pyrrolizidine alkaloids It is highly likely to be misdiagnosed and missed the diagnosis In this article ， recent research progresses on SOS were summarized ， aiming to enhance the understanding ， clinical diagnosis and treatment of this disease 【Key words】Drug-induced liver injury ； Sinusoidal obstruction syndrome ； Pyrrolidine alkaloids； Defibrotide 在药品性肝损伤（DILI）中，根据受损靶细胞类型，可分为肝细胞损伤型、胆汁淤积型、混合型以及肝血管损伤型等 4 种类型。其中，肝血管损伤型 DILI 的临床类型涉及肝窦阻塞综合征（SOS）、紫癜性肝病（PH）、布加综合征（BCS）等，这是由于受损的靶细胞累及不同部位如肝窦、肝小静脉、肝静脉主干或门静脉等的内皮细胞...
