Drug-induced Liver Disease Blood Serum Zymogram Change Feature And Prognostic Analysis

Background&AimsAccordingly with the sum of drugs growing in the clinic in recent years,the occurrence rate of Drug-induced Liver Disease also correspondly increased.To analyze the incidence,etiology,clinical characteristics prognosis and diagnostic accuracy of drug-induced liver disease(DILD).The aim of this study was to analyze the outcome of patients with severe DILD and evaluate the most important predictors,and to provide evidence for the choice of the clinical drug.MethodsTwo hundred and fifty six cases with drug-induced liver disease admitted to our hospital in a 10-year period were reviewed retrospectively.Drug history,clinical symptom and signs,laboratory tests and therapeutic effect were recorded.The liver damage was characterized according to hepatocellular,cholestatic,and mixed laboratory criteria and to histological criteria when available.Through the detection of the zymogram and analysis of the serum zymogram characteristics,determined the clinical value of prognosis judgement in each of them in the Drug-induced Liver Disease.Results1.Two hundred and fifty six cases with drug-induced liver disease were admitted to our hospital in a 10-year period.The on-set peak age was between 30～49 year-old in 256 cases of DILD in this study.The incidence male/female ratio was 0.72:1.2.71.5%(183/256) was classified as hepatocellular,cause by Chinese herbal medicine(23.8%),anti-tuberculosis drug(10.9%),antibiotics(9.8%); 19.5%(50/256) was classified as cholestatic type,cause by anti-thyroid drugs(5.5%),anti-neoplastic agent and 9.0%(23/256) as mixed type.3.Chinese herbal medicine and anti-tuberculosis drug were stood out as the most common drugs related to DILD. 4.The ALT,GGT,serum total protein,albumin and AST increased obviously in the group of the hepatocellular type,compared with the group of the cholestatic type(P＜0.05).The LDH,Bilirubin elevated obviously in the cholestatic type compared with the hepatocellular type(P＜0.05).5.No specific clinical manifestations of drug.The major symptoms were jaundice, anepithymia,abdominal pain,nausea and vomit.Some cases were asymptomatic.Misdiagnosis was not rare.6.In the total 256 cases,the death ratio were 6.6%.While antituberculous drugs are the primary etiological factor of fetal DILDs.7.Hepatic encephalopathy,ascite,jaundice,alcohol abuse and direct bilirubin levels are associated with the death of the patients with DILD.ConclusionsThe incidence of DILD were in an up-growing trend.The on-set peak age were between 30～49 year-old.The incidence of female was higher than that of male,with the ration of 1:0.72.herbal medicine,Anti-tuberculosis drugs,antibiotics drugs were the most frequent hepatoxic factors.No specific clinical manifestations,Misdiagnosis was not rare.Hepatocellular type was the most common drug-induced liver disease,with ALT,GGT,serum total protein,albumin and AST increasing obviously.Cholestatic hepatitis was the second most frequent type,with ALP,jaundice,direct bilirubin,LDH increasing obviously.Hepatic encephalopathy,ascite jaundiceand direct bilirubin levels were associated with the death of the patients with DILD.