Analysis of clinical features and prognostic factors of acute drug induced liver injury associated with low molecular weight heparin
10.13699/j.cnki.1001-6821.2017.17.003
- VernacularTitle:低分子肝素治疗肺血栓栓塞症引起急性药物性肝损伤的临床特征及预后因素分析
- Author:
Zi-Nan ZHAO
1
;
Ya-Tong ZHANG
;
Xin HU
Author Information
1. 北京医院药学部、国家老年医学中心
- Keywords:
low molecular weight heparin;
drug induced liver injury;
pulmonary thromboembolism;
prognostic factor;
risk evaluation
- From:
The Chinese Journal of Clinical Pharmacology
2017;33(17):1621-1624
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical features and prognostic factor of acute drug induced liver injury (DILI) associated with low molecular weight heparin (LMWH) in pulmonary thromboembolism patients.Methods International recognized Roussel Uclaf causality assessment method 2015 (RUCAM) was taken as standard.Basic clinical date,prescriptions and laboratory of pulmonary thromboembolism (PTE) patients in use of LMWH was collected and analyzed.Results Among 92 patients with acute DILI,according to RUCAM,there were 82.61％ with quite high probability and high probability (≥6).The hepatocellular injury type accounted for 18 patients (19.57％),mixed type accounted 45 patients (48.91％) and cholestatic type of DILI accounted for 29 patients (31.52％).Basic analysis showed the levels of alanine transaminase (ALT),aspartate aminotransferase (AST),alkaline phosphatase (ALP) and total bilirubine (TBIL) had statistically significant difference among 3 groups (P ＜ 0.05).Multivariate analysis indicated that severe infection (P ＜ 0.05) and high level of serum creatinine (Scr,P ＜ 0.05) were the independent adverse prognostic factors of mixed type and hepatocellular injury type of DILI,respectively.There was no statistically significant difference in the time to apparent onset of the reaction,the time upon the top level of abnormal liver function and outcomes among the 3 groups of DILI (P ＞ 0.05).Conclusion It is necessary to dynamically evaluate the liver function during hospitalization especially patients are with severe infection and/or high level of Scr.Specific treatment can be necessary in according with the type of DILI.
