Clinical Factors Research Of Drug Induced Liver Injury

Background:Drug induced liver injury(DILI)refers to liver injury induced caused by various chemically synthesized drugs,biologicals,traditional Chinese medicine,health care products,dietary supplements,and their metabolites[1].At present,DILI has become one of the most common causes of liver damage and adverse drug reaction in clinical practice,because of the increase of clinical drug types and the cure rate can be controlled such as HBV and HCV.According to statistics,more than 30,000 drugs and chemical may have potential hepatotoxicity[2],and more than 1,100 chemical or biological drugs have been known to have hepatotoxi city[3,4].China has a wide variety of drugs including chemical drugs,biological agents are used by treatment disease in non-standard;according to the situation in our country,the Chinese people believe in traditional Chinese medicine,it’s widely used;and with science and technology advancements,the drugs are increasing but medical personal and the public still have insufficient awareness of drug safety issues and DILI,leading to the increasing incidence and threat to human health of drug induced liver injury[5-7],the part of patients develop liver failure and even die.However,to attach importance to DILI,detection early,diagnosis early and treatment early is the best way of reducing the harm of liver damage.Objectives:To discusses the incidence of drug-induced liver injury clinical features and prognosis it aims to reduce the occurrence and harm of DILI and improve the clinical understanding of drug induced liver injury used by retrospective analysis method.Methods:A total of 154 patients with drug induced liver damage in the First Affiliated Hospital of Dali University in Yunnan Province from January 2016 to September 2020 were chosen as the research subjects,and all the selected cases met the commonly used diagnostic criteria for DILI in China[5].Through collecting the clinical data,including name,the age,sex,medication hi story,the changes of liver function index and blood routine index,and clinical classification of liver damage,liver damage degree and prognosis judgement,and age group structure,sex ratio,the main drugs,clinical manifestation,clinical classification and prognosis of liver damage in patients with DILI were analyzed,and the corresponding conclusions.Results:There are totally 154 patients including 59 males(38.31%)and 95 females(61.69%),with the age 6-72 years old,the average age was 44.1±14.31,including 72 patients(46.75%)aged 0-44 years old,59 patients(38.31%)aged 45-59 years old,and 23 patients(14.94%)aged 60-74 years old.Common medicines causing drug-induced liver injury were traditional Chinese medicines(63 cases,accounting for 40.91%),anti-tuberculosis drugs(27 cases,accounting for 17.53%),anti-tumor drugs(17 cases,accounting for 11.04%),immune inhibitor(8 cases,accounting for 5.19%),antibacterial agents(8 cases,accounting for 5.19%),the drugs treatment of endocrine diseases(3 cases,accounting for 1.95%)and antipsychotic agents(3 cases,accounting for 1.95%),non-steroid anti-inflammatory drug(3 cases,accounting for 1.95%),abortifacient(3 cases,accounting for 1.95%),cholesterol-lowering drugs(2 cases,accounting for 1.30%),contraceptive(2 cases,accounting for 1.30%),the drugs treatment of digestive tract diseases(1 cases,accounting for 0.65%),other(14 cases,accounting for 9.09%);The Clinical classification liver cell type(77.92%),cholestasis type(13.64%),mixed(8.44%).Among 154 cases,mild liver damage was the most(91 cases,59.09%),moderate liver damage(20 cases,12.99%)and severe liver damage(21 cases,13.64%)and liver failure(22 cases,14.28%)was similar,five of liver failure were transferred for artificial liver support system.After treatment,among of 154 patients,29cases were cured(18.83%),37cases turn better(24.03%),and 88cases does not improve(57.14%).Among the 120 cases of liver cell type,61 cases does not improve(50.8%),15 cases does not improve(71.4%)of the cholestasis type,12 cases does not improve(92.3%)of the mixed.The mixed type has the worst prognosis.Conclusions:(1)Drug induced liver injury was more common in women,the main drugs caused drug induced liver injury is traditional Chinese medicines,anti-tuberculosis drugs and anti-tumor drugs.(2)The clinical manifestations without obvious specificity,it’s similar to those of other types of livers diseases.(3)The main Clinical classification in patients liver cell type and mild liver injury.(4)There was no significant difference between men and women incidence among the three clinical types.(5)The degree of liver damage caused by western medicine is less than that caused by traditional Chinese medicines.(6)The mixed type has the worst prognosis.