Clinical Analysis Of153Cases Of Drug-induced Liver Injury

Background: Drug-induced liver injury (Drug-induced Liver Injury DILI) refers tothe disease induced by hepatotoxicity damage or liver allergic reaction caused by drugsor their metabolites during drugs treatment process, also known as drug hepatitis. Withthe continuous increase in new drugs and combined use of multiple drugs, widely usedin Chinese herbal medicine and herbal preparations, drug-induced liver injury incidenceincreased year by year. Because there are no standard diagnostic criteria for DILI, manypatients with DILI have been ignored in clinical, especially in patients with otherdiseases and other type hepatitis. Although the course of the disease is short and theprognosis is good, there still some patients progress to liver failure, and even to death.Medication history, primary disease, drug allergy history, symptoms and signs,laboratory examination should be collected in detail. To improve the understanding ofdrug-induced liver injury, make the early diagnosis and treatment. To make furtheranalysis of drugs-induced DILI classification, clinical features and prognosis, having abetter understanding of the disease, to improve the accuracy of diagnosis, and providebasis for clinical research on DILI.Purposes: To investigate the causes, treatments and prognosis of DILI and explorethe relationship between the clinical outcome of DILI and chronic primary diseasesthrough analyzing clinical manifestations and laboratory examination. To providereference for early diagnosis in DILI.Methods:153cases of patients, admitted for abnormal liver function, andultimately diagnosed as drug-induced liver injury, were collected in The SecondAffiliated Hospital of Dalian Medical University from2002to2013. They wereevaluated according to the sex, age, history of allergies, medication history, clinicalmanifestation, laboratory examination, imaging examination and condition afterstopping drug. liver function (alanine aminotransferase ALT, aspartate aminotransferaseAST, alkaline phosphatase ALP,γ-glutamyltransferase enzyme γ-GGT,. total bilirubinTBIL) before and after treatment in all patients were compared. The influence ofdifferent therapeutic regimen on the prognosis of the disease was evaluated. Re-evaluation can be made according to the Maria drug-induced liver disease scoringsystem in1997.Results: The incidence ratio between male and female is1:1.7among all153cases of drug-induced liver disease patients,, male:56, female:97. The youngest is2years old, the oldest is82years old. The average is48years old.7cases under20years old (5%),36cases of21-40years old (24%),64cases of41-60years old (41%),46patients older than60years (30%). Chinese herbal medicine is the most commondrug that induced liver injury with. western medicine mainly include antipyreticanalgesic, immune inhibitor, antituberculosis drugs, antibiotics. the main clinicalmanifestations were fatigue, nausea,vomiting, fever, loss of appetite, yellow urine,jaundice, Itch of skin. Stopping drug used and live protective treatment lead to betterprognosis.Conclusions: Through this research, we should pay more attention todrug-induced liver damage, to understand drug (including prescription drugs,over-the-counter drugs, herbal medicine, Chinese drugs preparation, weight-reducingaid, health care products etc.) components, medication time, indications, strengtheningsupervision of drugs. Clinicians should be familiar or mastering the drug ingredients,contraindication, and adverse reaction, the main drugs types resulting in drug-inducedliver injury, time of medication, medication and whether complicating with otherdiseases.