Clinical features of patients with different types of acute drug-induced liver injury: A comparative analysis

Yu WANG; Lixia QIU; Zuopeng FAN; Jingjing SONG; Jing ZHANG; Yutao ZHAN

doi:10.3969/j.issn.1001-5256.2021.03.025

Volume 37 Issue 3

Mar. 2021

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Article Navigation > Journal of Clinical Hepatology > 2021 > 37(3): 632-635

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Clinical features of patients with different types of acute drug-induced liver injury: A comparative analysis

DOI: 10.3969/j.issn.1001-5256.2021.03.025

1.
Department of Gastroenterology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
2.
Third Department of Liver Disease Center, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China

Received Date: 2020-10-21
Accepted Date: 2020-12-03
Published Date: 2021-03-20

Abstract

Abstract

Objective To investigate the clinical features of patients with different types of acute drug-induced liver injury (DILI) through a retrospective analysis. Methods Clinical data were collected from 790 patients who were diagnosed with acute DILI in Beijing YouAn Hospital and Beijing Tongren Hospital affiliated to Capital Medical University from December 2010 to March 2019, and according to the type of damaged target cell, the patients were divided into hepatocellular injury type group with 554 patients, cholestasis type group with 99 patients, and mixed type group with 137 patients. The patients were evaluated based on severity grade and score, clinical outcome, and Hy′s rule. An analysis of variance was used for comparison of normally distributed continuous data between three groups, and the least significant difference t-test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between groups. The chi-square test was used for comparison of categorical data between three groups. The Kruskal-Wallis H test was used for comparison of ranked data between three groups, and the Mann-Whitney U test was used for comparison between two groups. Results Most of the patients were female in all three groups, and the hepatocellular injury type group had a significantly higher proportion of female patients than the cholestasis type group (70.8% vs 54.5%, P < 0.05), and the cholestasis type group had a significantly lower proportion of female patients than the mixed type group (54.5% vs 54.7%, P < 0.05). There were 244 patients with grade 3 hepatocellular injury type DILI (244/554, 44.1%), 56 patients with grade 3 cholestasis type DILI (56/99, 56.6%), and 46 patients with grade 3 mixed type DILI (46/137, 33.6%), and there was a significant difference between the three groups (χ²=36.589, P < 0.05). Drugs inducing liver injury included traditional Chinese medicine, Western medicine, combination of traditional Chinese medicine and Western medicine, and other drugs, among which traditional Chinese medicine was the most common cause of liver injury. There was a significant difference in the outcome at discharge between the patients with different types (H=14.390, P=0.001). Compared with the cholestasis type group, the hepatocellular injury type group had a significantly higher cure rate and significantly lower uncured rate and mortality rate (all P < 0.05). Among the 554 patients with hepatocellular injury type DILI, 388 (70.0%) met Hy′s rule and 166 (30.0%) did not meet Hy′s rule, and there was a significant difference in clinical outcome between these two groups (U=38 372.0, P=0.033). Conclusion DILI is more common in women, and most patients have hepatocellular injury type DILI. Traditional Chinese medicine is the main cause of liver injury. There is a high proportion of patients with severe DILI among the patients with hepatocellular injury type or cholestasis type. DILI often has good prognosis with a relatively low mortality rate. Hy′s rule cannot predict the death of patients with acute DILI.
- Chemical and Drug Induced Liver Injury,
- Hepatocyte Injury,
- Cholestasis

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会议时间：2024年6月5—8日

会议地点：意大利米兰

会议网站： https://www.easlcongress.eu/

2024年欧洲肝病学会年会将于2024年6月5日—8日在意大利米兰举行。本次大会将汇集7 000多名专业人员，包括临床医生、研究人员、联合卫生专业人员、患者代表和行业专业人员

本次大会反应肝脏相关复杂问题的各种主题和观点。从前沿研究到互动研讨，为参会人员提供全面的经验交流，推动肝病领域向前发展。

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Clinical features of patients with different types of acute drug-induced liver injury: A comparative analysis

DOI: 10.3969/j.issn.1001-5256.2021.03.025

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Clinical features of patients with different types of acute drug-induced liver injury: A comparative analysis

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