The Clinical Features Analysis Of 102 Cases With Drug-induced Liver Disease

Background and Objective Drug-induced liver disease(DILD) refers to liver damage caused by drugs or metabolites, which is one of the common causes of this liver disease. More than one thousand kinds of drugs have been found that they can cause liver damage, and the list of drugs presents a trend of extending gradually. Because of the atypical clinical manifestations, the complex pathology and the lack of specific diagnostic markers in laboratory, DILD is often overlooked or missed or misdiagnosed. Drug-induced liver disease is difficult and hot issue of liver disease research, which causes great concern. In order to improve the clinicians' awareness of this disease and to guide clinical diagnosis and treatment, the correlation analysis on the clinical characteristics of drug-induced liver disease is made in this paper.Method Collecting 102 cases of hospitalized DILD patients from Binhai New Area Infectious Disease Hospital in Tianjin; excluding viral liver disease, alcoholic liver disease, hereditary metabolic liver disease and autoimmune liver disease and making retrospectively investigation analysis; recording sex, age, the type and name of drugs which cause this disease; analysis on the time period from using drugs to paroxysm, the main clinical symptoms and type, liver function and coagulation checking index, clinical grading, treatment, prognosis and so on; statistical Methods, including Level data which uses rank sum test, count data which using X2 test and comparison of two sample rates which is tested through Fisher's exact test and Pearson ?2 test.(P <0.05 can be considered to have statistically meaning)Result Among 102 patients, there are 46 male and 56 female cases, aged 20-78 years old. 65 of them(63.7%) had acute DILD, while 37 of them(36.3%) had chronic DILD; With herbal medication as the main medical type, others are anti-TB drugs, chemotherapeutic agents, anti-inflammatory drugs, health drugs, antibiotics, hypoglycemic agents, glucocorticoids, antipsychotic drugs and so on. 88 of them(86.2%) use a single drug, while 14 of them(13.8%) use combination therapy. Paroxysm concentrates on more in summer and autumn but less in winter. The main clinical symptoms are fatigue, gastrointestinal symptoms, dark urine, fever, rash, pruritus, while only four cases are asymptomatic. There are four clinical types. About 62.7% of patients are hepatocytes, and cholestasis type accounts for about 19.6%, while mixing type accounts for about 17.6%. ALT and AST is higher in hepatocellular type, while ALP and TBil is higher in cholestasis. Severe liver damage and acute liver failure accounts for a higher proportion in the degree of liver injury, which were 36 cases(35.3%) and 30 cases(29.4%), while there are 3 cases of deaths.Conclusion 1. Drug-induced liver disease(DILD) most occurred among the elderly, particularly among female patients. 2. Chinese herbal medicine is a major reason which causes drug-induced liver disease or drug-induced liver injury. And anti-TB drugs, chemotherapy drugs, and anti-inflammatory drugs are main western medicines that cause DILD. 3. The main clinical type is hepatocellular damage one. Most of patients were in good prognosis and their indicators of liver function returned to normal, while the prognosis of liver failure patients are relatively poor. 4. Drug-induced liver disease should be paid more adequate attention and get earlier treatment.