Clinical Analysis Of Drug-induced Liver Injury And Research On The Levels Of TSP-1, IL-6 And IL-10 In Serum

Objectives: To Analyze the types of drugs that cause drug-induced liver injury(DILI),and study the clinical features of DILI,including its clinical manifestations,typing and prognosis.The contents of TSP-1,IL-6 and IL-10 in the serum of DILI patients were detected,and their roles and clinical significance in the pathogenesis of DILI were preliminarily discussed.Methods:1.Retrospective analysis was used to collect the clinical data of 133 patients with DILI diagnosed in the affiliated Hospital of Hebei Engineering University from December 2016 to February 2019.The age,gender,BMI,medical history,drugs causing liver injury,test results,clinical manifestations,clinical classification,liver injury severity classification and prognosis of the enrolled patients were recorded in detail.2.Inpatients and health check-ups who attended the Affiliated Hospital of Hebei Engineering University from March 2019 to September 2019 were taken as the research objects.A total of 58 cases were included,of which 40 patients admitted to DILI were selected as the experimental group,and 18 healthy physical examinees in our hospital were selected as the control group.With the informed consent of the Ethics Committee and the patients,2-5ml venous blood was taken in fasting state in the early morning and centrifuged at 3000r/min for 10 minutes.The serum was separated and stored at-80?.The contents of TSP-1,IL-6 and IL-10 in serum of each group were determined by enzyme-linked immunosorbent assay kit.Results:1.133 cases of DILI included 57 males and 76 females,with a male-to-female ratio of 1:1.3 and an average age of(54.66±17.64)years.The incidence of the disease was the highest in 77(57.89%)patients aged 50-70 years.2.The score of RUCAM was 6-8,with 103 cases(77.44%).Grade 1 of liver injury severity scale accounted for the largest proportion of 78 cases(58.65%).3.The most clinical classification was hepatocellular injury,with 101 cases(75.94%),cholestasis type in 20 cases(15.04%),and mixed type in 12 cases(9.02%).4.The most common clinical manifestations were gastrointestinal symptoms,such as nausea,vomiting and poor appetite,with a total of 55 cases(41.35%).5.The top 3 drugs causing liver injury were Chinese traditional medicine andproprietary Chinese medicine in 32 cases(24.06%),anti-tumor drugs in 23 cases(17.29%),and anti-microbial drugs in 21 cases(15.79%).6.A total of 97 patients(72.93%)were discharged after treatment,20 patients(15.04%)recovered,15 patients(11.28%)failed treatment,and 1 patient died(0.75%).Logistic analysis showed that the prognostic risk factor was TBIL(OR = 0.952,P =0.011).7.The serum levels of TSP-1,IL-6 and IL-10 in 40 DILI patients were significantly higher than those in the control group(P<0.05).8.Spearman correlation analysis showed that serum TSP-1 level in DILI patients was positively correlated with TBIL,ALT and AST(P<0.05).IL-6 was positively correlated with TBIL,ALT and AST(P<0.05).IL-10 was positively correlated with TBIL,ALT and AST(P<0.05).Conclusions:1.133 cases of DILI were more common in female and middle-aged and elderly patients.Most of the liver injuries caused by DILI are of low severity,and the types of injuries are mainly liver cell injuries.There is no specificity in clinical manifestations,but mostly gastrointestinal symptoms.The first drug to cause DILI is Chinese medicine and proprietary Chinese medicine.Most patients have a good prognosis.2.The expression levels of TSP-1,IL-6 and IL-10 in the serum of 40 patients with DILI were significantly increased,and the expression levels were positively correlated with ALT,AST and TBIL,indicating that the three were involved in the pathogenesis of DILI,and the expression levels were related to the severity of liver inflammation.The regulation of TSP-1 expression level may be a new direction for the treatment of DILI.