Clinical Analysis Of 208 Cases Of Drug - Induced Liver Injury In Qinghai Area

Objective:To investigate the facts of drug-induced liver injury (DILI),includingdrug types,the clinical manifestations and prognosis of patients with DILI, toimprove clinicians’ understanding of DILI and the level of the diagnosis andtreatment of DILI.Methods:The clinical data of208patients with DILI diagnosed and treated in theAffiliated Hospital of Qinghai University during June2006to June2012wereretrospectively collected. And their general information, medication types, clinicalfeatures, biochemical test results, prognosis and its influencing factors were analyzed.Results:The study found that DILI patients diagnosed in our hospital in the past5years was increasing year by year. The rate of cure or recovery of patients with DILIwas92.3%. The old ones ware more likely to be attacked, people older than sixtyaccounts for40.9%in all patients with DILI. The liver injury usually appeared in oneto twelve weeks after taking the corresponding drug. The top three categories of drugscausing DILI were Chinese herbal medicines, anti-TB drugs and antibiotics,whichaccounted for66.3%in all drugs. Hepatocellular injury, which accounts for54.3%,was the most common type in the clinical classification. The early symptoms of DILIinclude anorexia, annoying greasy, nausea, fatigue, liver discomfort, sclera yellow dye,etc. These symptoms often occurred in one to twelve weeks after taking thecorresponding drugs. Some patients may have no symptoms. There was significantdifference in prognosis between mixed type and hepatocellular injury type (P<0.0125),however, no significant differences between cholestatic type and hepatocellular injurytype or between cholestatic type and mixed type. The prognosis of the DILI inducedby different types of drugs and the prognosis of patients in different age weresimilar,the statistical differences were meaningless.Conclusions:The incidence of DILI is gradually increasing in last5years. Cliniciansshould fully grasp the drug’s indications and contraindications in order to avoidiatrogenic liver injury. DILI was usually induced in one to twelve weeks after takingthe corresponding drugs and was often found in the elderly people over the age of60 years old. The spectrum of drugs which could result in drug-induced liver injury waswide, the top type of drugs induced DILI was Chinese herbal medicine, it wasfollowed by anti-TB drugs and antibiotic drugs. The majority of DILI clinical typewas hepatocellular injury type. The earliest symptoms were anorexia, annoying greasy,nausea, fatigue, liver discomfort, sclera yellow dye, etc. They usually occurred duringin one to twelve weeks after taking the drug. It was clinical type rather than the typeof drugs or age at onset have an impact on the prognosis of drug-induced liver injury,for the type of drugs and age at onset have no obvious difference in prognosis.