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GLP-1受体激动剂致药物性肝损伤的文献病例分析 Δ

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张梦华 ，朱 颖 ，吴紫阳 ，王艳花 ，熊祥樽 ，缪丽燕 [1.苏州大学附属第一医院药学部，江苏 苏州 215006；
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2.昆明医科大学附属第二医院药学部，昆明 650101；3.重庆大学附属中心医院（重庆市急救医疗中心）药学部，
重庆 400010]
中图分类号 R969.3 文献标志码 A 文章编号 1001-0408（2025）20-2561-05
DOI 10.6039/j.issn.1001-0408.2025.20.13

摘 要 目的 探讨胰高血糖素样肽-1 受体激动剂（GLP-1RAs）致药物性肝损伤（DILI）的临床特征，为临床安全用药提供参考。
方法 以“GLP-1”“GLP-1RAs”“司美格鲁肽”“药物性肝损伤”等为检索词，检索PubMed、Embase、the Cochrane Library、中国知网、
万方数据和维普网，收集GLP-1RAs致DILI的相关文献并进行描述性分析。结果 共纳入11篇文献，共计11例患者。11例患者
中，男性4例（36.4%）、女性7例（63.6%）；患者年龄为17～64岁，其中50～65岁患者5例（45.5%）；6例用于治疗糖尿病，5例用于减
重；10例患者伴有基础疾病；DILI发生时间最短的为用药后5 d，最长约180 d；GLP-1RAs致DILI以肝细胞损伤型为主（6例），严重
程度包括重度（3例）、中度（6例）、轻度（2例），临床表现包括消化道症状、黄疸等；10例患者的DILI与GLP-1RAs的关联性为“很可
能”，1例为“可能”；11例患者均经停药及（或）对症治疗后好转。结论 GLP-1RAs致DILI相对集中于50～65岁人群，以女性为主，
合并基础疾病的患者发生风险增加。临床应加强高危人群识别、用药教育（尤其是症状识别）等药学监护；出现相关症状时应立即
停药，必要时给予保肝治疗，以保障患者的用药安全。
关键词 胰高血糖素样肽-1受体激动剂；药物性肝损伤；文献病例分析；安全性

Literature case analysis of drug-induced liver injury induced by GLP-1 receptor agonists
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ZHANG Menghua ，ZHU Ying ，WU Ziyang ，WANG Yanhua ，XIONG Xiangzun ，MIAO Liyan [1. Dept. of
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Pharmacy， the First Affiliated Hospital of Soochow University， Jiangsu Suzhou 215006， China；2. Dept. of
Pharmacy， the Second Affiliated Hospital of Kunming Medical University， Kunming 650101， China；3. Dept. of
Pharmacy， Chongqing University Central Hospital （Chongqing Emergency Medical Center）， Chongqing
400010， China]
ABSTRACT OBJECTIVE To investigate the clinical characteristics of drug-induced liver injury （DILI） induced by glucagon-
like peptide-1 receptor agonists （GLP-1RAs）， and to provide a reference for safe clinical medication. METHODS Using search
terms such as “GLP-1”“GLP-1RAs”“semaglutide” “drug-induced liver injury”， relevant studies from PubMed， Embase， the
Cochrane Library， CNKI， Wanfang Data and VIP were retrieved. Descriptive analysis was performed on cases of DILI induced by
GLP-1RAs. RESULTS A total of 11 studies， comprising 11 patients， were included. Among them， 4 were male （36.4%） and 7
were female （63.6%）. Patient ages ranged from 17 to 64 years； 5 patients （45.5%） were between 50 and 65 years old. Six patients
were treated for diabetes， and five for weight loss. Ten patients had underlying diseases. The shortest time to the onset of DILI was
5 days after medication， while the longest was approximately 180 days. The DILIs induced by GLP-1RAs were mainly
hepatocellular injury type （6 cases）； severity levels included severe （3 cases）， moderate （6 cases）， and mild （2 cases）.
Gastrointestinal symptoms and jaundice were the most common clinical manifestations. The association between DILI and GLP-
1RAs was assessed as “probable” in 10 cases and “possible” in 1 case. All 11 patients improved after drug discontinuation and （or）
corresponding treatment. CONCLUSIONS DILI induced by GLP-1RAs is relatively concentrated in patients aged 50-65， with a
higher incidence in females. The risk may be further increased in patients with underlying diseases. Clinical use of these agents
should enhance pharmaceutical care， including identification of high-risk populations and patient education （especially symptom
recognition）. When relevant symptoms appear， the drug
Δ 基金项目 江苏省医学重点学科和医学重点实验室项目（No.苏
should be discontinued immediately， with liver-protective
卫科教〔2022〕17号）
＊ 第一作者 药 师 ，硕 士 。 研 究 方 向 ：临 床 药 学 。 E-mail： therapy initiated when necessary， to ensure patient safety of
zmh20121111@163.com drug use.
# 通信作者 主任药师，教授，博士生导师，博士。研究方向：临床 KEYWORDS GLP-1 receptor agonists； drug-induced liver
药学、个体化药物治疗。E-mail：miaolysuzhou@163.com injury； literature case analysis； safety

中国药房 2025年第36卷第20期 China Pharmacy 2025 Vol. 36 No. 20 · 2561 ·