Clinical features of Polygonum multiflorum preparation-related liver injury with or without positive autoantibody
10.3969/j.issn.1001-5256.2022.10.018
- VernacularTitle:首乌制剂相关肝损伤伴或不伴自身抗体阳性患者临床特征比较
- Author:
Jing CAI
1
;
Guiqin ZHOU
2
;
Yaxing LIU
2
;
Bin LI
2
;
Xiaojing WANG
2
;
Ying FENG
2
;
Xianbo WANG
2
Author Information
1. The First Clinical Medical College, Beijing University of Chinese Medicine, Beijing 100700, China
2. Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
- Publication Type:Original Article_Other Liver Diseases
- Keywords:
Chemical and Drug Induced Liver Injury;
Fallopia multiflora;
Autoantibodies
- From:
Journal of Clinical Hepatology
2022;38(10):2296-2301
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features of patients with Polygonum multiflorum preparation-related liver injury with or without positive autoantibody based on propensity score matching, as well as the influence of positive autoantibody on the prognosis of such patients. Methods A total of 364 patients with Polygonum multiflorum preparation-related liver injury who were hospitalized in Beijing Ditan Hospital, Capital Medical University, from August 2008 to June 2021 were enrolled, and according to whether autoantibodies were detected, they were divided into negative autoantibody group (H0 group) with 157 patients and positive autoantibody group (H1 group) with 207 patients. After adjustment for confounding factors by propensity score matching, the two groups were compared in terms of biochemical parameters, severity of liver injury, classification of liver injury, and disease outcome when liver injury reached the peak. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Mann-Whitney U rank sum test was used for comparison of categorical data or ranked data between two groups. The Cox regression model was used to analyze the influencing factors for liver function recovery. The Kaplan-Meier method was used to plot survival curves, and the Log-rank test was used for comparison between groups. Results A total of 98 pairs of cases were successfully matched after propensity score matching. Comparison of biochemical parameters between the two groups at the peak of liver injury showed that compared with the H0 group, the H1 group had significantly higher levels of alkaline phosphatase (ALP), globulin, and total bile acid and a significantly lower level of albumin (all P < 0.05). There was no significant difference in the classification of liver injury between the two groups ( P > 0.05), and there was a significant difference in the severity of liver injury between the two groups ( Z =1.710, P =0.045). Antinuclear antibody (ANA) was the main positive autoantibody and accounted for 49%, and there was a significant difference in the severity of liver injury between the patients with different ANA antibody titers ( Z =20.252, P =0.001). Comparison of disease outcome in terms of whether liver function returned to normal within 6 months showed that the normalization rate of liver function within 6 months was 90.8% in the H0 group and 75.5% in the H1 group, and the H1 group had a lower normalization rate of liver function ( χ 2 =8.199, P =0.004). The Cox regression analysis showed that autoantibody (hazard ratio [ HR ]=5.248, 95% confidence interval [ CI ]: 1.554-17.718, P =0.008) and ALP ( HR =1.013, 95% CI : 1.002-1.025, P =0.026) were independent risk factors for liver function recovery. The Kaplan-Meier survival curve analysis showed that compared with the negative autoantibody group, the positive autoantibody group had a significantly higher risk of failure in liver function recovery after 6 months ( χ 2 =8.802, P =0.003). Conclusion Autoantibody has no significant influence on the classification of Polygonum multiflorum preparation-related liver injury, and compared with the patients with negative autoantibody, the patients with positive autoantibody tend to have more severe liver injury and a more obvious tendency of chronicity.
