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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 5
May  2014
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Article Contents

Clinical characteristics of drug-induced liver injury: an analysis of 394 cases

DOI: 10.3969/j.issn.1001-5256.2014.05.014
  • Published Date: 2014-05-20
  • Objective To analyze the clinical characteristics of drug- induced liver injury ( DILI) . Methods A retrospective analysis was performed on the clinical data of 394 patients with DILI who were admitted to our hospital from 2009 to 2011. The studied factors included age, sex, names and categories of toxic drugs, time of onset, liver function, whether liver biopsy was performed, treatment, and prognosis. Results There is an upward trend in cases of DILI. Among the 394 patients with DILI, 170 ( 43. 15%) were males, and 224 ( 56. 85%) were females; the male- to- female ratio was 1∶ 1. 3; the peak ages were 41- 50 years ( 25. 63%) and 51- 60 years ( 25. 13%) . A variety of drugs could cause DILI, with traditional Chinese medicines ( TCMs) ( 45. 43%) as the most common one, followed by a combination of drugs ( 11. 42%) and antitubercular drugs ( 7. 61%) . The TCM category mainly included those for treating osteoarthrosis ( 11%) and dermatosis ( 11%) , and the drug names and components were mostly unknown. Forty- three cases ( 10. 91%) were confirmed by pathological examination, and the common pathological changes included infiltration of neutrophils and eosinophils ( 65. 01%) and cholestasis of capillary bile ducts ( 39. 93%) , which had no specificity for clinical diagnosis, but provided some hint. Among the 394 patients, 102 ( 25. 89%) were cured, 184 ( 46. 70%) showed an improvement, and 7 ( 1. 78%) progressed to liver failure and death. The overall prognosis was good; the prognostic factors included age, clinical classification, and peak level of total bilirubin. Conclusion A variety of drugs can cause DILI, which has no specific clinical manifestations and gold diagnostic criteria, often leading to misdiagnosis; most cases have good prognosis, but liver failure may occur in some cases.

     

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  • [1]WANG YZ, ZHANG Y.Clinical analysis of drug-induced liver injury in the elderly[J].China Med Herald, 2012, 9 (14) :80-82. (in Chinese) 王悦之, 张玉.老年药物性肝损伤临床特点分析[J].中国医药导报, 2012, 9 (14) :80-82.
    [2]Cooperative group of Hepatobiliary Disease of Digestive Disease Branch of Chinese Medical Association.Advice of diagnosis and treatment of drug-induced liver injury (draft) [J].Chin J Dig, 2007, 27 (11) :765-767. (in Chinese) 中华医学会消化病学分会肝胆疾病协作组.药物性肝损伤诊治建议 (草案) [J].中华消化杂志, 2007, 27 (11) :765-767.
    [3]MA B, LIU SC.Clinical analysis of 179 patients with acute druginduced liver injury[J].Chin J Gastroenterol Hepatol, 2008, 17 (3) :246-248. (in Chinese) 马博, 刘思纯.急性药物性肝损伤179例临床分析[J].胃肠病学和肝病学杂志, 2008, 17 (3) :246-248.
    [4]SHAO CP, WU CH, LI J, et al.Clinical characteristics analysis of122 patients with drug-induced liver injury[J].Chin Hepatol, 2012, 17 (9) :451-453. (in Chinese) 邵翠萍, 吴赤红, 李俊, 等.122例药物性肝损伤临床特点分析[J].肝脏, 2012, 17 (9) :451-453..
    [5]Cooperative Group of Hepatobiliary Disease of Digestive Disease Branch of Chinese Medical Association.A multicenter survey on hospital inpatients with drug-induced acute liver injury in China[J].Chin J Dig, 2007, 27 (7) :439-442. (in Chinese) 中华医学会消化病学分会肝胆疾病协作组.全国多中心急性药物性肝损伤住院病例调研分析[J].中华消化杂志, 2007, 27 (7) :439-442.
    [6]WANG Y, ZHAO LF, WANG QY.Clinical analysis of 66 patients with drug-induced liver injury[J].Chin J Hepatol, 2010, 18 (8) :715-716. (in Chinese) 王艳, 赵龙凤, 王勤英.药物性肝损伤66例分析[J].中华肝脏病杂志, 2010, 18 (8) :715-716.
    [7]XIONG LS, JIA JD, OU XJ, et al.Clinical characteristics analysis of 78 patients with drug-induced liver injury[J].J Clin Hepatol, 2011, 27 (10) :1062-1065. (in Chinese) 熊良圣, 贾继东, 欧晓娟, 等.药物性肝损伤78例临床特点分析[J].临床肝胆病杂志, 2011, 27 (10) :1062-1065.
    [8]LUO Y, CHEN YQ, SUN L, et al.Clinical analysis of drug-induced liver injury caused bu anti-tb drugs[J].Chin J Infect Dis, 2007, 25 (4) :247-249. (in Chinese) 罗雁, 陈营清, 孙丽, 等.抗结核药致药物性肝损伤的临床分析[J].中华传染病杂志, 2007, 25 (4) :247-249.
    [9]Tuberculosis Disease Branch of Chinese Medical Association.Expert advice of diagnosis and treatment of drug-induced live injury caused by anti-tb drugs[J].Chin J Tuberc Respir Dis, 2013, 36 (10) :732-736. (in Chinese) 中华医学会结核病分会, 抗结核药所致药物性肝损伤诊断与处理专家建议[J].中华结核和呼吸杂志, 2013, 36 (10) :732-736.
    [10]SU HB, WANG HF.Pay attention to drug-induced liver failure[J].J Clin Hepatol, 2012, 28 (10) :1062-1065. (in Chinese) 苏海滨, 王慧芬.关注药物性肝衰竭[J].临床肝胆病杂志, 2012, 28 (10) :738-739.
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