Clinical Characteristics And Correlation Analysis Between Risk Factors And Prognosis Of Drug-induced Liver Injury

Objective: To summarize the clinical characteristics,risk factors and prognosis of drug-induced liver injury(DILI)in our hospital for the past few years,in order to better understand the characteristics of DILI and judge the progress and prognosis of the disease.Methods: The clinical data of 458 DILI patients with RUCAM score ≥3 in the Second Hospital of Hebei Medical University from January 2014 to September 2020 were collected.The clinical characteristics and specific drug use of DILI patients were analyzed retrospectively.Logistic regression analysis was used to study the factors affecting the prognosis of DILI patients.Results: Among the 458 cases of DILI,there were 182 males(39.74%)and 276 females(60.26%).There were 288 middle-aged and elderly people aged 45 and over(62.88%),which showed a high incidence of DILI.The main clinical manifestations were anorexia,fatigue,anorexia,abdominal distension,nausea,vomiting,yellow urine and other symptoms,as well as varying degrees of skin,mucous membrane,sclera yellow staining.The most kinds of drugs causing DILI were traditional Chinese medicine and health products(38.86%).In clinical classification,hepatocyte type accounted for the majority(350 cases,76.42%)and severe type(148 cases,32.31%).Most of the patients with DILI had a good prognosis,cured in 13 cases(2.84%),improved in 421cases(91.92%),and uncured / other 24 cases(5.24%).Univariate analysis revealed that the prognosis of DILI patients was correlated with previous chronic liver disease,clinical classification,severity,TBIL,DBIL,PA,PT,PA(%)and INR.Multivariate Logistic regression analysis showed that severity,TBIL and INR were independent risk factors for the prognosis of DILI.Conclusions: There are many kinds of drugs leading to DILI,traditional Chinese medicine is the most common cause,and the clinical classification is mainly hepatocyte type.Most of the patients with DILI have a good prognosis through active treatment and intervention,and the severity,TBIL and INR can be used as independent indexes to evaluate the prognosis of patients with DILI.