Analysis Of Case Characteristics Of 109 Patients With Drug-induced Liver Injury

Objective:To analyze the drug types that have cause drug-induced liver injury(DILI)in recent years,to study the clinical features,treatment and prognosis of DILI,and to provide evidence for clinicians to diagnose drug-induced liver injury and prevent drug-induced liver damage recurrence.Methods:Collecting the clinical data of 109 patients with DILI who visited our hospital from2016 to 2018,including clinical history,symptoms and signs,suspected medications for DILI,underlying diseases,test and examination results,treatment and prognosis,and retrospective analysis.Results:1.Of the 109 patients with drug-induced liver damage,36(33%)were males and73(67%)were females.The male to female ratio was 1:2.02,the age distribution was(15-82)years old,and the average age was 49.31±15.30.In the age of 40 years old,81cases(74%).2.Drug types:37 cases(33.9%)of traditional Chinese medicine,60 cases(55.0%)of western medicine,7 cases(6.4%)of Chinese and Western medicine,and 5 cases(4.7%)of health products were used.Traditional Chinese medicines mainly include two kinds of dosage forms: decoction,pill and medicine.Western medicine mainly includesantipsychotic drugs,anti-infective drugs,cardiovascular and cerebrovascular diseases,thyroid diseases and anti-tuberculosis drugs.3.Clinical manifestations: mainly fatigue,nausea,anorexia,jaundice,rare symptoms such as itchy skin,dry mouth,joint pain,etc.4.According to CIOMS specified standard classification(calculated R value),hepatocyte injury type 86 cases(79%),cholestasis type 17 cases(16%),mixed type 6cases(5%).According to the course of disease,104 cases(95%)were acute drug-induced liver injury and 5 cases(5%)were chronic drug-induced liver injury.According to the type of medication,37 cases(34%)of DILI caused by traditional Chinese medicine,67cases(61%)of DILI caused by western medicine,and 5 cases(5%)of DILI caused by health care products.Of the 109 patients with DILI,3 had acute liver failure,all of which were hepatocyte injury.5.Treatment: 103 patients(94%)who discontinued suspicious medication according to the condition after admission,and 6 patients(6%)who had suspicious drug reduction.Patients with elevated transaminase were treated with reduced glutathione and magnesium isoglycyrrhizinate;those with obvious cholestasis were treated with adenosine succinate and ursodeoxycholic acid.Hepatic failure and severe cholestasis are treated with hormone and non-biological artificial liver.6.Prognosis: 89 cases(82%)were cured,18 cases(17%)improved,and 2 cases(1%)were treated with automatic discharge.Conclusion:Women with drug-induced liver injury are more common in men than men,and the age distribution is mostly in middle-aged and elderly patients.Traditional Chinese medicine,mental illness medication,cardiovascular disease medication,antibiotics,anti-tuberculosis drugs,and thyroid disease medications are common drugs that causeDILI.The clinical classification of this group of patients is the most common type of hepatocyte injury,and most patients have a good prognosis after active treatment.The key to the treatment of DILI is to remove harmful drugs as soon as possible.The primary disease must be reduced by the drug of the healer,and the liver protection,strict monitoring of disease changes and liver function indicators should be strengthened.When using drugs that may cause liver damage,especially in women and middle-aged and elderly patients,the risk of developing DILI is high,and it is necessary to closely monitor liver function,and to observe the toxic side effects of the drug.