中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 5
May  2014

Clinical characteristics of drug-induced liver injury: an analysis of 394 cases

DOI: 10.3969/j.issn.1001-5256.2014.05.014
  • Published Date: 2014-05-20
  • Objective To analyze the clinical characteristics of drug- induced liver injury ( DILI) . Methods A retrospective analysis was performed on the clinical data of 394 patients with DILI who were admitted to our hospital from 2009 to 2011. The studied factors included age, sex, names and categories of toxic drugs, time of onset, liver function, whether liver biopsy was performed, treatment, and prognosis. Results There is an upward trend in cases of DILI. Among the 394 patients with DILI, 170 ( 43. 15%) were males, and 224 ( 56. 85%) were females; the male- to- female ratio was 1∶ 1. 3; the peak ages were 41- 50 years ( 25. 63%) and 51- 60 years ( 25. 13%) . A variety of drugs could cause DILI, with traditional Chinese medicines ( TCMs) ( 45. 43%) as the most common one, followed by a combination of drugs ( 11. 42%) and antitubercular drugs ( 7. 61%) . The TCM category mainly included those for treating osteoarthrosis ( 11%) and dermatosis ( 11%) , and the drug names and components were mostly unknown. Forty- three cases ( 10. 91%) were confirmed by pathological examination, and the common pathological changes included infiltration of neutrophils and eosinophils ( 65. 01%) and cholestasis of capillary bile ducts ( 39. 93%) , which had no specificity for clinical diagnosis, but provided some hint. Among the 394 patients, 102 ( 25. 89%) were cured, 184 ( 46. 70%) showed an improvement, and 7 ( 1. 78%) progressed to liver failure and death. The overall prognosis was good; the prognostic factors included age, clinical classification, and peak level of total bilirubin. Conclusion A variety of drugs can cause DILI, which has no specific clinical manifestations and gold diagnostic criteria, often leading to misdiagnosis; most cases have good prognosis, but liver failure may occur in some cases.

     

  • [1]WANG YZ, ZHANG Y.Clinical analysis of drug-induced liver injury in the elderly[J].China Med Herald, 2012, 9 (14) :80-82. (in Chinese) 王悦之, 张玉.老年药物性肝损伤临床特点分析[J].中国医药导报, 2012, 9 (14) :80-82.
    [2]Cooperative group of Hepatobiliary Disease of Digestive Disease Branch of Chinese Medical Association.Advice of diagnosis and treatment of drug-induced liver injury (draft) [J].Chin J Dig, 2007, 27 (11) :765-767. (in Chinese) 中华医学会消化病学分会肝胆疾病协作组.药物性肝损伤诊治建议 (草案) [J].中华消化杂志, 2007, 27 (11) :765-767.
    [3]MA B, LIU SC.Clinical analysis of 179 patients with acute druginduced liver injury[J].Chin J Gastroenterol Hepatol, 2008, 17 (3) :246-248. (in Chinese) 马博, 刘思纯.急性药物性肝损伤179例临床分析[J].胃肠病学和肝病学杂志, 2008, 17 (3) :246-248.
    [4]SHAO CP, WU CH, LI J, et al.Clinical characteristics analysis of122 patients with drug-induced liver injury[J].Chin Hepatol, 2012, 17 (9) :451-453. (in Chinese) 邵翠萍, 吴赤红, 李俊, 等.122例药物性肝损伤临床特点分析[J].肝脏, 2012, 17 (9) :451-453..
    [5]Cooperative Group of Hepatobiliary Disease of Digestive Disease Branch of Chinese Medical Association.A multicenter survey on hospital inpatients with drug-induced acute liver injury in China[J].Chin J Dig, 2007, 27 (7) :439-442. (in Chinese) 中华医学会消化病学分会肝胆疾病协作组.全国多中心急性药物性肝损伤住院病例调研分析[J].中华消化杂志, 2007, 27 (7) :439-442.
    [6]WANG Y, ZHAO LF, WANG QY.Clinical analysis of 66 patients with drug-induced liver injury[J].Chin J Hepatol, 2010, 18 (8) :715-716. (in Chinese) 王艳, 赵龙凤, 王勤英.药物性肝损伤66例分析[J].中华肝脏病杂志, 2010, 18 (8) :715-716.
    [7]XIONG LS, JIA JD, OU XJ, et al.Clinical characteristics analysis of 78 patients with drug-induced liver injury[J].J Clin Hepatol, 2011, 27 (10) :1062-1065. (in Chinese) 熊良圣, 贾继东, 欧晓娟, 等.药物性肝损伤78例临床特点分析[J].临床肝胆病杂志, 2011, 27 (10) :1062-1065.
    [8]LUO Y, CHEN YQ, SUN L, et al.Clinical analysis of drug-induced liver injury caused bu anti-tb drugs[J].Chin J Infect Dis, 2007, 25 (4) :247-249. (in Chinese) 罗雁, 陈营清, 孙丽, 等.抗结核药致药物性肝损伤的临床分析[J].中华传染病杂志, 2007, 25 (4) :247-249.
    [9]Tuberculosis Disease Branch of Chinese Medical Association.Expert advice of diagnosis and treatment of drug-induced live injury caused by anti-tb drugs[J].Chin J Tuberc Respir Dis, 2013, 36 (10) :732-736. (in Chinese) 中华医学会结核病分会, 抗结核药所致药物性肝损伤诊断与处理专家建议[J].中华结核和呼吸杂志, 2013, 36 (10) :732-736.
    [10]SU HB, WANG HF.Pay attention to drug-induced liver failure[J].J Clin Hepatol, 2012, 28 (10) :1062-1065. (in Chinese) 苏海滨, 王慧芬.关注药物性肝衰竭[J].临床肝胆病杂志, 2012, 28 (10) :738-739.
  • Relative Articles

    [1]Xueying LIU, Huihui SHI, Haowen WANG, Tao YANG. The material basis and toxic mechanism of herb-induced liver injury[J]. Journal of Clinical Hepatology, 2024, 40(8): 1512-1518. doi: 10.12449/JCH240802
    [2]Chenghai LIU. Research advances and challenges in herb-induced liver injury[J]. Journal of Clinical Hepatology, 2024, 40(8): 1505-1511. doi: 10.12449/JCH240801
    [3]Yinuo DONG, Yang ZHI, Jieting TANG, Yimin MAO. Diagnosis of herb-induced liver injury: Challenges in practice[J]. Journal of Clinical Hepatology, 2024, 40(8): 1533-1537. doi: 10.12449/JCH240805
    [4]Tingting HE, Zhaofang BAI, Jiabo WANG, Xiaohe XIAO. Phenotypic characteristics and toxicological mechanisms of herb-induced liver injury[J]. Journal of Clinical Hepatology, 2024, 40(8): 1525-1532. doi: 10.12449/JCH240804
    [5]Xin SUN, Qiong LUO, Tao YANG, Chenghai. LIU. Management and treatment of herb-induced liver injury[J]. Journal of Clinical Hepatology, 2024, 40(8): 1538-1542. doi: 10.12449/JCH240806
    [6]Hui ZHENG, Rong SUN. Influence of combined drug administration on herb-induced liver injury[J]. Journal of Clinical Hepatology, 2024, 40(8): 1519-1524. doi: 10.12449/JCH240803
    [7]Luo Qiong, Zhu GeRui, Gu HongTu, Liu Kun, Chen GaoFeng, Xing Feng, Tao YanYan, Liu ChengHai. Liver histopathological features of patients with drug-induced liver injury due to Chinese herbal medicine or Western medicine: A comparative analysis of 50 cases[J]. Journal of Clinical Hepatology, 2020, 36(3): 596-601. doi: 10.3969/j.issn.1001-5256.2020.03.025
    [8]Chen Jun. Drug-induced liver injury caused by Chinese herbal medicine cannot be neglected[J]. Journal of Clinical Hepatology, 2018, 34(6): 1169-1171. doi: 10.3969/j.issn.1001-5256.2018.06.006
    [9]Liu ChengHai, Zhu ChunWu. Epidemic features, major causes, and diagnostic evaluation of herb-induced liver injury[J]. Journal of Clinical Hepatology, 2017, 33(5): 829-832. doi: 10.3969/j.issn.1001-5256.2017.05.007
    [10]Zhu Yun, Wang RuiLin, Sun XueYing, Yu SiMiao, Jing Jing, Wang JiaBo, He TingTing, Huang YiXue, Wang LiPing, Sun YongQiang. Guiding significance of Guideline for diagnosis and treatment of herb-induced liver injury in clinical diagnosis: a retrospective analysis[J]. Journal of Clinical Hepatology, 2016, 32(11): 2159-2162. doi: 10.3969/j.issn.1001-5256.2016.11.032
    [11]Branch of Hepatobiliary Diseases, China Association of Chinese Medicine, Branch of Chinese Patent Medicine, China Association of Chinese Medicine. Guideline for diagnosis and treatment of herb-induced liver injury[J]. Journal of Clinical Hepatology, 2016, 32(5): 835-843. doi: 10.3969/j.issn.1001-5256.2016.05.003
    [12]Drug-induced Liver Disease Study Group, Chinese Society of Hepatology, Chinese Medical Association. Guidelines for the management of drug-induced liver injury[J]. Journal of Clinical Hepatology, 2015, 31(11): 1752-1769. doi: 10.3969/j.issn.1001-5256.2015.11.002
    [13]Li JingTao, Chang ZhanJie, Xi Qi, Liu YaZhu, Song ChunRong, Nan Ran, Li RiXiang, Wei HaiLiang, Yan ShuGuang. HCV culture system and its application in antiviral research on Chinese herb extracts in vitro[J]. Journal of Clinical Hepatology, 2015, 31(1): 115-117. doi: 10.3969/j.issn.1001-5256.2015.01.026
    [14]Hu XingWu, Qi ChangJin, Zhou HongXing. Therapeutic efficacy of ursodeoxycholic acid for drug-induced liver disease[J]. Journal of Clinical Hepatology, 2012, 28(9): 695-696.
    [15]Yu XiaoFang. Captopril-induced liver injury and considerations for hepatitis[J]. Journal of Clinical Hepatology, 2012, 28(7): 549-550.
    [16]Su HaiBin, Wang HuiFen. Clinical significance of drug-induced liver failure[J]. Journal of Clinical Hepatology, 2012, 28(10): 738-739+747.
    [17]Wang ChunYan, Li Bing. One case of congenital hepatic fibrosis and hepatitis B virus infection and drug-induced liver injury[J]. Journal of Clinical Hepatology, 2011, 27(12): 1318-1319.
    [18]Li Yang, Xu JianMing. Clinical analysis of 11 cases of hepatic veno-occlusive disease caused by Chinese herbal medicine[J]. Journal of Clinical Hepatology, 2011, 27(2): 140-142.
    [19]Zhu ChaoHui, Li Nan, Wu Kai, Wang XueMing, Zhang Lin, Zhai JunShan, Wang YanMei. The effect of S-adenosyl-methionine treatment on drug-induced liver injury[J]. Journal of Clinical Hepatology, 2010, 26(6): 651-653.
  • Created with Highcharts 5.0.7Amount of accessChart context menuAbstract Views, HTML Views, PDF Downloads StatisticsAbstract ViewsHTML ViewsPDF Downloads2024-052024-062024-072024-082024-092024-102024-112024-122025-012025-022025-032025-04051015202530
    Created with Highcharts 5.0.7Chart context menuAccess Class DistributionFULLTEXT: 7.4 %FULLTEXT: 7.4 %META: 84.4 %META: 84.4 %PDF: 8.2 %PDF: 8.2 %FULLTEXTMETAPDF
    Created with Highcharts 5.0.7Chart context menuAccess Area Distribution其他: 2.5 %其他: 2.5 %其他: 0.6 %其他: 0.6 %China: 0.2 %China: 0.2 %India: 0.4 %India: 0.4 %[]: 1.2 %[]: 1.2 %上海: 2.7 %上海: 2.7 %丽水: 0.4 %丽水: 0.4 %兰州: 0.2 %兰州: 0.2 %北京: 6.6 %北京: 6.6 %南京: 2.7 %南京: 2.7 %南宁: 0.6 %南宁: 0.6 %台州: 1.8 %台州: 1.8 %吉林: 0.8 %吉林: 0.8 %周口: 0.4 %周口: 0.4 %嘉兴: 0.4 %嘉兴: 0.4 %宣城: 0.2 %宣城: 0.2 %巴音郭楞: 0.2 %巴音郭楞: 0.2 %张家口: 3.5 %张家口: 3.5 %成都: 0.8 %成都: 0.8 %拉斯维加斯: 0.6 %拉斯维加斯: 0.6 %文昌: 0.2 %文昌: 0.2 %昆明: 1.0 %昆明: 1.0 %杭州: 2.3 %杭州: 2.3 %武汉: 0.6 %武汉: 0.6 %泰州: 2.7 %泰州: 2.7 %深圳: 0.2 %深圳: 0.2 %湖州: 1.8 %湖州: 1.8 %芒廷维尤: 26.6 %芒廷维尤: 26.6 %芜湖: 0.2 %芜湖: 0.2 %芝加哥: 0.2 %芝加哥: 0.2 %莫斯科: 2.0 %莫斯科: 2.0 %衡阳: 0.4 %衡阳: 0.4 %衢州: 1.6 %衢州: 1.6 %西宁: 31.4 %西宁: 31.4 %重庆: 0.2 %重庆: 0.2 %长春: 1.0 %长春: 1.0 %长沙: 0.6 %长沙: 0.6 %其他其他ChinaIndia[]上海丽水兰州北京南京南宁台州吉林周口嘉兴宣城巴音郭楞张家口成都拉斯维加斯文昌昆明杭州武汉泰州深圳湖州芒廷维尤芜湖芝加哥莫斯科衡阳衢州西宁重庆长春长沙

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (3128) PDF downloads(760) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return