Research On The Clinical Characteristics And The Prognostic Influencing Factors Of The Drug-induced Liver Failure

Object: To investigate the etiology, clinical features, and prognosis of drug-induced liverfailure.Materials and methods: A retrospective analysis was performed on the clinical data ofpatients received and cured by the department of hepatic-billiary-pancreatic medicine of thefirst hospital of Jilin University, include75patients with drug-induced liver failure betweenJanuary2005to December2014. The studied factors included age, sex and categories of toxicdrugs, allergies, past history, time of onset, complications, liver function, blood routine, bloodcoagulation function, blood glucose, etc.Results: Of these75patients with an average age of(39.79±17.86)years，23were male(30.67%) and52were female (69.33%), the high risk age of the disease is31~40years oldand51~60years old. The most common drugs that caused DILI is herbal medicine (44.00%),followed by anti-TB drugs (18.67%), antibiotics (8.00%) and anti-inflammatory drugs(8.00%). The middle time of onset is30days. The most common underlying diseases in DILIis tuberculosis (14cases), followed by skin diseases (11cases) respiratory tract infection (7cases).66patients had complications, the most common complication is hepaticencephalopathy (60cases), followed by electrolyte disorders (21cases) and acid-base balance(21cases). The predominant types of drug-induced liver failure are acute drug-induced liverfailure (60%) and subacute drug-induced liver failure (29.33%). There are no significantstatistical difference between western drugs and Chinese herbal (P>0.05). A total of6cases(8%) of the patients were cured and10(13.3%) were improve,14(18.67%) cases of thepatients were invalid, and45(60%) cases of the patients were dead. Gender, age, drugallergies, liver failure type, drug type had no significant effect on the prognosis of patients.Prognostic factors incude underlying diseases, the number of complications (≥2months),PTA, TBIL, CHE and glucose (P<0.05). Conclusion:1. The median onset time of drug-induced liver failure is30days.2. The main causes of drug-induced liver failure are Chinese herbal, anti-TB drugs andantibiotics.3. The main basic diseases accompanied with Drug-induced liver failure are diseasetuberculosis, skin diseases and upper respiratory infections.4. The incidence of Drug-induced liver failure was significantly higher in women thanin men; the dangerous age group are31to40years old and51to60years.5. The most common complication of Drug-induced liver failure are hepaticencephalopathy, followed by electrolyte and acid-base imbalance.6. The main types of drug-induced liver failure are acute drug-induced liver failure andsubacute drug-induced liver failure.7. Drug-induced liver failure have poor prognosis and high mortality, basic diseases,the number of complications (≥2) affected the prognosis.8. The values of PTA,TBIL, CHE and glucose are good predictions for drug-inducedliver failure.