Clinical features of patients with drug-induced liver injury in Shaanxi Province from 2009 to 2019
10.3969/j.issn.1001-5256.2023.06.016
- VernacularTitle:陕西省2009—2019年药物性肝损伤患者的临床特征分析
- Author:
Qian WANG
1
;
Mimi LIU
1
;
Kaini HE
1
;
Xiaoyan GUO
1
Author Information
1. Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
- Publication Type:Original Article_Other Liver Disease
- Keywords:
Chemical and Drug Induced Liver Injury;
Symptoms and Signs;
Prognosis
- From:
Journal of Clinical Hepatology
2023;39(6):1358-1365
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features of patients with drug-induced liver injury (DILI). Methods A retrospective analysis was performed for the clinical data of 1 376 patients with DILI who were admitted to 20 hospitals in Shaanxi Province, China, from 2009 to 2019 and were diagnosed with RUCAM scale as the diagnostic criteria, and these patients were analyzed in terms of sex, age, underlying diseases, suspected drugs causing DILI, clinical manifestations, laboratory examination, treatment process, and prognosis. The t -test and Wilcoxon test were used for comparison of continuous data between two groups, the chi-square test was used for comparison of categorical data between groups, and the Kruskal-Wallis H rank sum test was used for comparison of ordered polytomous data between groups. Results Among the 1 376 patients, there were 577(41.93%) male patients and 799 (58.07%) female patients, with a male/female ratio of 0.72:1. As for different age groups, the 40-60 years group had a higher incidence rate and accounted for 44.77%, and there was a significant difference in sex distribution between different age groups ( χ 2 =20.784, P =0.008). As for the three clinical types, there was no significant difference in incidence rate between men and women ( χ 2 =1.409, P =0.494), and there was a significant difference in the distribution of clinical types between different age groups ( χ 2 =47.025, P < 0.001). The top three drugs causing DILI were traditional Chinese medicine (41.13%), antitubercular agents (11.70%), and antipyretic and analgesic drugs (7.27%). Hepatocellular injury type was the main clinical type and accounted for 65.77% (905 cases). The mean length of hospital stay was 15.31 days, mostly 1-4 weeks which accounted for 91.86%. Among these 1376 patients, 45 (3.27%) were cured and 1 322 (96.08%) were improved, suggesting a good overall prognosis. The patients with different clinical types had significantly different prognoses ( H =59.300, P =0.011), and further comparison showed that the patients with hepatocellular injury type and mixed type had a significantly better prognosis than those with cholestasis type ( P < 0.05), while there was no significant difference in prognosis between the patients with hepatocellular injury type and those with mixed type ( P > 0.05). Conclusion There is a high incidence rate of DILI in women and middle-aged and elderly people, and traditional Chinese medicine is the leading cause of DILI. Patients with different clinical types tend to have different prognoses, with a good overall prognosis.
