Clinical feature and prognosis of patients with drug-induced liver injury:An analysis of 219 cases
Objective The purpose of this study was to summarize the clinical features and prognosis of patients with drug-induced liver injury(DILI).Methods The clinical data of 219 hospitalized patients with DILI was analyzed,who were encountered in First Affiliated Hospital,Guangxi Medical University between January 2012 and December 2020.The diagnosis was made by the RUCAM score≥6.The suspect medicines,clinical features,disease severity and outcomes were retrospectively analyzed,and the disease severity was classified as mild,moderate and severe.Results In our series of 219 patients with DILI,the top five suspected medicines that most frequently caused DILI were Chinese herbal medicine(30.1%),anti-tuberculosis agents(12.3%),antibiotics(11.9%),anti-tumor and immunosuppressive medicines(7.8%)and antipyretic analgesics(6.4%);the clinical types included hepatocyte injury type in160 cases,cholestasis type in42 cases and mixed type in17 cases;there was no significant differences in gender and age distribution among the three types of clinical types(P>0.05);there were100 patients with disease severity of grade 1,32 patients with grade 2 and 87 patients with grade 3 or above;the percentages of severe type in patients with cholestasis type and mixed type were57.1%and53.0%,both significantly higher than33.7%(P<0.05)in patients with hepatocyte injury;the recovery rate in patients with hepatocyte injury was 93.8%,much higher than 61.9%in patients with cholestasis type or 70.6%in patients with mixed type(P<0.01).Conclusion The common suspected medicines which could lead to DILI in clinical practice are mainly traditional Chinese herbal medicines,anti-tuberculosis agents and antibiotics.The clinical classification is mainly hepatocellular injury type,and the proportions of severe liver injury in patients with cholestasis and mixed type are significantly higher than that in those with hepatocyte injury type.The outcomes of patients with hepatocyte injury is relatively promising.