关键词: 药物性肝损伤, 临床特点, 中成药, 预后

Abstract: Objective The purpose of this study was to summarize the clinical features and prognosis of patients with drug-induced liver injury (DILI). Methods The clinical materials in 164 patients with DILI between January 2015 and December 2019 were reviewed. The diagnosis of DILI was in accordance with the guidelines for the diagnosis and treatment of drug-induced liver injury reported by the Hepatology Branch of the Chinese Medical Association in 2015. Results Out of the 164 patients with DILI, the hepatocyte injury type was found in 97, the cholestasis type in 24, and the mixed type in 43; the average age in patients with hepatocyte injury was (47.2±13.3)yr, significantly younger than those in other two groups (P<0.05); serum ALT level in patients with hepatocyte injury was (652.5±350.6)U/L, in other two groups , significantly higher than those serum AST level was (451.8±418.1)U/L, much higher than in other two groups , while serum ALP level in patients with cholestasis type was (268.8±212.8)U/L, significantly higher than in other two groups , and serum bilirubin level was (66.8±13.5)μmol/L, also significantly higher than in other two groups ; the western medicine-, herbal medicine- and both-induced DILI accounted for 27.4%, 64.6% and 7.9%, respectively; the average age in 45 patients with western medicine-induced DILI was (44.2±13.5)yr, significantly younger than in other two groups (P<0.05), and male accounted for 42.2%, significantly higher than 33.0% in 106 patients with herbal medicine-induced DILI or 30.8% in 13 patients with western and herbal medicine-induced DILI; serum ALT level in western medicine-induced DILI was (510.2±361.8)U/L, significantly higher than , serum AST level was (360.8±251.5)U/L, significantly higher than in other two groups, while serum ALP level in herbal medicine-induced DILI was (174.7±113.6)U/L, much higher than in other two groups , and serum bilirubin level was (93.9±46.2)μmol/L, significantly higher than in other two groups ; 141 patients recovered and 23 not in our series; the male accounted for 52.2% in those unrecovered, significantly higher than 32.6%(P<0.05) in recovered, the hepatocyte injury accounted for 39.1%, significantly lower than 62.4%(P<0.05) in recovered, and herbal medicine-induced accounted for 78.2%, much higher than 62.4% (P<0.05) in recovered. Conclusion The clinical features of patients with DILI in our series are common with good prognosis, and the patients with herbal medicine-induced DILI tend to be with hyperbilirubinemia, whom should be taken more attention and dealt with appropriately.

Key words: Drug-induced liver injury, Clinical features, Herbal medicine, Prognosis