关键词: 药物性肝损伤, 临床特征, 病理学特征, 预后

Abstract: Objective The aim of this study was to summarize clinical and pathological features of a series of patients with drug-induced liver injury (DILI). Methods 113 patients with DILI were encountered in our hospital between January 2022 and December 2024, and all patients underwent liver biopsies. Types and degrees of liver injury were classified based on clinical materials. Results Of the 113 patients with DILI, there were 58 cases (51.3%) with hepatocyte injury type, 20 cases (17.7%) with cholestasis type and 35 cases (31.0%) with mixed type; proportion of jaundice in patients with mixed was 71.4%,much higher than 55.0%(P<0.05) in those with and cholestasis types, proportions of ≥class 3 liver injury in patients with mixed and cholestasis types were 54.2% and 55.0%,both much higher than 34.5%(P<0.05) in those with hepatocyte injury; serum total bilirubin levels in patients with mixed and cholestasis types were(55.2±12.8)μmol/L and (59.7±14.2)μmol/L, both significantly higher than [(23.5±11.6)μmol/L,P<0.05],and INR were (1.5±0.2) and (1.3±0.2), both much greater than [(1.0±0.2),P<0.05] in those with hepatocyte injury; in terms of pathological manifestations, patients with hepatocyte injury presented with hepatocyte ballooning degeneration and focal necrosis, patients with cholestasis type exhibited with cholestasis and bile duct injury, and patients with mixed type demonstrated with hepatocyte injury and cholestasis; after one to three week treatment, 55 patients (94.8%)with hepatocyte injury, 15 patients (75.0%)with cholestasis type and 28 patients (80.0%)with mixed type recovered. Conclusion The clinical manifestations of patients with DILI are usually nonspecific, and hepatocyte type is the most common clinical classification. The main pathological characteristics of liver include inflammatory cell infiltration, hepatocyte swelling and necrosis. After discontinuing suspected drugs and active liver protection treatment, there is a good prognosis in most patients with DILI.

Key words: Drug-induced liver injury, Clinical feature, Pathological manifestation, Prognosis