| Objective:In this study, through the treatment of acute drug-induced liver injury(DILI), explore the treatment success rate and survival quality of patients with acute DILI.Methods:From January 1, 2005 to December 31, 2013, a total of 60 cases of acute DILI. 50 cases of elderly group, 18 cases of male, 32 cases of women; Aged from 60 to 86, 31 cases(62.3%) of 60 ~ 69 years old, 18 cases(35.8%) of 70 ~ 79 years old, 1 case(1.9%) of 80 ~ 86 years old. 110 cases of young and middle-aged group, 40 cases of men, 70 women, aged from 18 to 59 years old. 60 patients with drug-induced liver failure, 30 cases in treatment group were treated for protect liver. At the same time,nutritional support and symptomatic treatment on the basis of the blood filtration combined blood perfusion. On conlusion,protect liver plus hemofiltration joint blood perfusion therapy; The rest of the 30 control subjects were given liver symptomatic treatment. Analysis:(1) Acute DILI drug category differences between elderly group and young and middle-aged group.(2) The clinical symptoms between elderly group and young and middle-aged group.(3) After 0, 1, 2, 3, 7, 14 days treatment,what were liver founctions differences between elderly group and young and middle-aged group.(4) Before and after treatment the hepatic function indexes between elderly group and young and middle-aged group.(5) After treatment of 0, 1, 2, 3, 7, 14 days, what were liver function differences between elderly group and young and middle-aged group. ⑹liver function before and after the treatment in drug-induced hepatic failure patients. ⑺Adverse reactions comparision in patients with drug-induced liver failure between the treatment group and the control group.Results:(1) In acute DILI, Chinese herbal medicine accounted for the majority situation in both old and young and middle-aged group. It accounted for about half.(2) The elderly group compared with the young and middle-aged group, use more cardiovascular system drugs(P<0.05).(3) The elderly group and young and middle-aged group after treatment of 0, 1, 2, 3, 7, 14 days of liver function. ALT, AST, ALP, GGT, TBA, TBIL, DBIL, TP and ALB slowly improved. After treatment, ALT, GGT, TBA, TBIL, DBIL had statistical difference(P < 0.05) between elderly group and young and middle-aged groups. Young and middle-aged group had bilirubin fade faster.(4) Before treatment, elderly group compared with the young and middle-aged group, ALT, AST, ALP, GGT, TBA, TBIL, DBIL, TP and ALB had no statistical difference(P > 0.05). After treatment, ALT, the GGT, TBA, TBIL, DBIL between elderly group and young and middle-aged groups had statistical difference(P < 0.05). Elderly group before and after treatment had ALT, AST, ALP, TBA, TBIL, DBIL, TP, ALB statistically difference(P < 0.05). Young and middle-aged group before and after treatment had ALT, AST, ALP, GGT, TBIL, DBIL, TP, ALB statistically difference(P < 0.05).(5) After treatment of 0, 1, 2, 3, 7, 14 days, the control group had liver function indexes including ALT, AST, ALP, GGT, TBA, TBIL, DBIL, TP and ALB slowly changing trend. The treatment group showed a trend of sharp fluctuations, immediately turned better after treatment(P < 0.05), after a short time recovered(P < 0.05). 3 d, 7 d, 14 d after treatment, showed the same trend again. 6. The treatment group and control group before treatment, ALT, AST, ALP, GGT, TBA, TBIL, DBIL, TP and ALB had no statistical difference(P > 0.05). After treatment, ALT, AST, ALP, GGT, TBA, TBIL, DBIL, TP, ALB between treatment group and control group had statistical difference(P < 0.05). The treatment group before and after treatment had ALT, AST, ALP, TBA, TBIL, DBIL, TP, ALB with statistically differences(P < 0.05). The control group before and after treatment had ALT, AST, ALP, GGT, TBIL, DBIL, TP, ALB with statistically differences(P < 0.05). ⑹ The treatment group compared with control group, the number of neutropenia was more for 7, the control group was only one. Other adverse reactions, such as granulocytopenia, abdominal distension, loss of appetite, nausea, fever hadno significant differences(P < 0.05). Therefore, the treatment group took hemofiltration joint blood perfusion and liver protecting treatment measures to treat disease. But did not affect the quality of life of patients compared with the control group.Conclusion:(1)In acute DILI, Chinese herbal medicine accounted for the majority situation in both old and young and middle-aged group. It accounted for about half.(2) The elderly group compared with the young and middle-aged group, use more cardiovascular system drugs.(3) The elderly group and young and middle-aged group after treatment of 0, 1, 2, 3, 7, 14 days had liver function. ALT, AST, ALP, GGT, TBA, TBIL, DBIL, TP and ALB slowly improved. After treatment, ALT, GGT, TBA, TBIL, DBIL had statistical difference between elderly group and young and middle-aged groups. Young and middle-aged group had bilirubin fade faster.(4) Before treatment, elderly group compared with the young and middle-aged group,ALT, AST, ALP, GGT, TBA, TBIL, DBIL, TP and ALB had no statistical difference. After treatment, ALT, the GGT, TBA, TBIL, DBIL between elderly group and young and middle-aged groups had statistical difference. Elderly group before and after treatment had ALT, AST, ALP, TBA, TBIL, DBIL, TP, ALB statistically difference. Young and middle-aged group before and after treatment had ALT, AST, ALP, GGT, TBIL, DBIL, TP, ALB statistically difference.(5) After treatment of 0, 1, 2, 3, 7, 14 days, the control group had liver function indexes including ALT, AST, ALP, GGT, TBA, TBIL, DBIL, TP and ALB slowly changing trend. The treatment group showed a trend of sharp fluctuations, immediately turned better after treatment, after a short time recovered. 3 d, 7 d, 14 d after treatment, showed the same trend again. ⑹The treatment group and control group before treatment, ALT, AST, ALP, GGT, TBA, TBIL, DBIL, TP and ALB had no statistical difference. After treatment, ALT, AST, ALP, GGT, TBA, TBIL, DBIL, TP, ALB between treatment group and control group had statistical difference. The treatment group before and after treatment had ALT, AST, ALP, TBA, TBIL, DBIL, TP, ALB with statistically differences. The control group before and after treatment had ALT, AST, ALP, GGT, TBIL, DBIL, TP, ALB with statistically differences. 6. The treatment group compared with control group, the number of neutropenia was more for 7, the control group was only one. Other adverse reactions, such as granulocytopenia, abdominal distension, loss of appetite, nausea, fever hadno significant differences. Therefore, the treatment group took hemofiltration joint blood perfusion and liver protecting measures to treat disease. So blood filtration joint blood perfusion did not affect the quality of life of patients compared with the control group. |
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