The Clinical Features And Diagnostic Analysis Of 158 Cases Of Drug-induced Liver Injury

Drug-induced liver injury has become one common disease in clinical medicine, its morbility and mortality are growing up every year ,this article does a retrospective research about the clinical features and something about the diagnosis of DILI.Objective:To enhance the further understanding of DILI, do some research on the diagnostic standard.Methods: The retrospective analysis was performed in this study to 158 patients diagnosed drug induced liver injury in Gastroenterology department and contagious department of our hospital from 2003 to 2007, The observing contents include:1.Epidemiology: sex, the relation of age and incidence rate, dringking alcohol or not, hypersensitiveness or not.2.Etiology: the category of drugs that induced liver injury.3.Clinical presentations: the occurring time of liver damage of all kinds of drugs; major symptoms.4.Laboratory data: the feature in serum of drug induced liver injury such as routine examination: blood routine tes, blood clotting test, function of the liver, all kinds of marker of hepatitis virus, autoantibody and so on. in addition, ultrasound is needed.5.The use of drugs that have liver damage was ceased immediately and comprehensively conservative therapy was needed when the diagnosis of drug induced liver injury was established. about acute liver failure, the use of fresh frozen plasma become one important measure, Artificial liver is become popular,liver transplantation is the ultimate method.Results:1.The proportion of male to female was 1:1.225, The on-set peak happened in the 40-59 year-old in 158 cases of DILI in this study.2.The category of drugs that induced liver injury: The most common drugs that induced liver damage are herbal medicine, antipyretic analgesic,antibiotics and antituberculosis drugs are the first three reason causing DILI in western medicine.3.Most of the liver damage induced by drugs appeared during 5 days to three months.4.Clinical presentations: No specific clinical presentation of DILI was found in this study. The peptic symptoms were fatigue, jaundice,nausea,apocleisis,abdominal distention,itch of skin and so on.5.The inceasing of the count of mononuclear leukocytosis (64.56%) is more obvious than that of eosinophilic cell (13.29%), the function of liver appeared abnormal differently degree, positive autoantibody is found in 24 Cases among 75 cases who underwent the examination. 20 cases appeared abnomal with the examination of blood blotting test.6. clinical classification: hepatocellular injury occupies 57.60%, cholestic liver injury occupies 22.78%, mixed liver injury occupies 19.62%.7.Coincidence of the diagnosis of DILI on the cases in our hospital comes up to 98.70% with the DDW-J standard, Negative rate is 1.30%. Coincidence of the diagnosis of DILI on the same cases comes up to 51.94%, with the Maria standard, Negative rate is 48.06%. we carried out the statistics analysis between the rates above, the result is P<0.05, the study presents significant difference.Conclusion:1.The proportion of male to female and the on-set peak consistent with literature.2.The structure of etiology changes.The most common drugs that induced liver damage are herbal medicine, antituberculosis drugs inducing liver injury has a increasing tendecy.3.On clinical classification ,hepatocellular injury occupies the first grade,this kind of liver injury happens acute liver failure in great chance.4.Most of the liver damage induced by drugs appeared during 5 days to three months.5.The inceasing of the count of mononuclear leukocytosis is more obvious than that of eosinophilic cell, perhaps it is more significant to apply mononuclear leukocytosis to the diagnostic cosensus of China.6.The classification of DILI can change during the clinical treatment, so we must monitor the function of liver interruptedly. 7.The DDW-J standard is comparative with the Maria standard, the former is coincident with Chinese diagnosis on DILI better.