Drug-induced Liver Injury Clinic Feature And Prognostic Analysis

BackgroundWith the advent of aging society and modern society changes of disease spectrum, organ disfunction in the old-aged Patients, complications of many diseases, continuous development of new drugs and a wide range of clinical applications, more and more patients are faced with the risk of drug-induced liver injury.In the chemical or biological drugs listed which are being applied, more than 1,100 drugs have potential liver toxicity:many drugs, excipients, herbal medicines and health care may also lead to liver injury. Alcohol and drug-induced liver failure is next to hepatitis virus in China. National multi-center retrospective investigation on cases of acute drug-induced liver injury in 2005 showed:Until June 2005,1541 hospitalized cases of acute drug-induced liver injury were reported from 16 hospitals in five years, the medical cases increase gradually. Among the 1376 cases which were actually available for analysis, there were 80 cases (5.81%) of severe drug-induced liver injury,17 patients died, the fatality rate was 1.24%. Consequently, it is particularly important to Strengthen the clinician on the knowledge of prevention,diagnosis and prognosis of drug-induced liver injury.However drug-induced liver injury is usually occult in onset, the clinical manifestation is nonspecific, prognosis forecast of DILI is lack of uniform standards, all of these need us to explore and research.Objective To investigate the relationship between clinical manifestation and prognosis of patients with drug-induced liver disease.Methods Retrospective analysis was performed among 135 patients with drug-induced liver disease from 2002-10～2009-10 of our hospital.The sex, age primary disease of patients and drug history, clinical symptoms, signs,laboratory tests and therapeutic effect were statistically analysed.Results DILI has the following features:①The incidence of DILI was higher in female than man;②The drugs that induced DILI were chiefly antitubercular drugs and Chinese herbal medicine.③Clinical manifestations were:acute hePatocellular lesions,78 cases(57.78%);acute cholestasis,32 cases(23.70%); mixed type25 cases(18.52%).④It was found that the lower ALB value the worse prognosis, while TBL, DBIL, PT was just the opposite.Conclusion The clinicians should attach importance to the prevention, diagnosis and therapy of drug-induced liver disease.