Clinical analysis of 348 cases of drug-induced liver damage / 西安交通大学学报(医学版)

ABSTRACT

【Objective】 To study the characteristics of drug-induced liver injury （DILI）. 【Methods】 A total of 348 cases of DILI treated in The First Affiliated Hospital of Xi’an Jiaotong University from January 2015 to December 2017 were collected and divided into the elderly group （96 cases） and the young and middle-aged group （252 cases）. We comprehensively described and analyzed the composition of underlying diseases， DILI drug use， clinical manifestations， the relationship between DILI classification and liver function， and prognostic factors. 【Results】 In the elderly group， the top three underlying diseases were cardiovascular and cerebrovascular diseases， digestive system diseases， diabetes， and metabolic diseases. In the young and middle-aged patients， the top three were digestive system diseases， respiratory system diseases， and cardiovascular diseases. In either of the two groups， all kinds of traditional Chinese medicine preparations accounted for the largest proportion， which was 50.0% and 47.6%， respectively. Among DILI patients， hepatocyte type was the most common， accounting for 53.3%， followed by cholestasis type （23.7%）， and mixed type （22.8%）. Age （OR=0.977）， length of hospital stay （OR=0.947） and immunosuppressant （OR=0.073） were protective factors for the prognosis of DILI patients， while aspartate aminotransferase （AST） （OR=1.001） was a risk factor for the prognosis of DILI patients. 【Conclusion】 The underlying diseases of DILI patients are complex， and there are many kinds of pathogenic drugs. Special attention should be paid to the liver injury of traditional Chinese medicine， and the clinical manifestations are lack of specificity. The prognosis of DILI patients is generally good， which still needs clinical attention， and the biochemical monitoring of liver function should be strengthened for key groups.