Page 7 - 《中国药房》2026年3期

·指南与共识·

肝损伤药物目录及合理用药专家共识
Δ

1 #
1
李健春 1， 2＊ ，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[1.北京医院药学部/国家老年医学中心/中国医学科学院老年医学研究院/北京市药物临床风险与个体化应用

评价重点实验室（北京医院），北京 100730；2.航天中心医院药剂科，北京 100049]

中图分类号 R969.3；R575 文献标志码 A 文章编号 1001-0408（2026）03-0273-08
DOI 10.6039/j.issn.1001-0408.2026.03.01

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——LiverTox A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LiverTox A、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。
关键词 肝损伤；合理用药；医院药学；专家共识

Expert consensus on the medication catalog for drug-induced liver injury and rational drug use
1
1， 2
LI Jianchun ，CHEN Di ，JIN Pengfei ，National Center of Gerontology， Geriatric Pharmacy Professional
1
Committee of the China Medicine Education Association， Pharmacy Management and Pharmaceutical Innovation
Branch of the Chinese Association of Geriatric Research， Pharmacy Management and Pharmacy Service Branch
of the Chinese Geriatrics Society， Geriatric Pharmacy Professional Committee of the Beijing Pharmaceutical
Association[1. Dept. of Pharmacy， Beijing Hospital/National Center of Gerontology/Institute of Geriatric
Medicine， Chinese Academy of Medical Sciences/Beijing Key Laboratory of Assessment of Clinical Drugs Risk
and Individual Application （Beijing Hospital）， Beijing 100730， China；2. Dept. of Pharmacy， Aerospace Center
Hospital， Beijing 100049， China]

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
Δ 基金项目 国家卫生健康委员会医药卫生科技发展研究中心
Consensus was formed. RESULTS & CONCLUSIONS This
项目（No.WKZX2023CX210007）；首都卫生发展科研专项（No. 首发
Consensus included 12 traditional Chinese medicines （TCMs）
2024-1-4052）
＊ 第一作者 药 师 ，硕 士 。 研 究 方 向 ：临 床 药 学 。 E-mail： such as Polygoni Multiflori Radix and Ephedrae Herba， 151
17854160130@163.com Western medicines including amiodarone and atorvastatin，
# 通信作者 主任药师，博士生导师，博士。研究方向：医院药学。 along with rational use information. For TCM， eight rational
E-mail：j790101@163.com use information were included： evidence-based score， liver

中国药房 2026年第37卷第3期 China Pharmacy 2026 Vol. 37 No. 3 · 273 ·