Abstract: Objective The purpose of this study was to investigate the common medicines and influencing factors on severity of liver injury in hospital stay patients with drug-induced liver injury (DILI). Methods 104 patients with DILI and 148 patients without DILI were encountered in our hospital between September 2018 and March 2022, and the severity of liver injury was evaluated based on guideline related. Some patients received liver biopsies. The influencing factors on the severity of liver injury was predicted by univariate and multivariate Logistic analysis. Results The alleged causative medicines in our series included Chinese herbal medicines in 39 cases (37.5%), antibiotics in 17 cases (16.3%), non-steroidal anti-inflammatory drugs in 13 cases (12.5%), cardiovascular drugs in 8 cases (7.7%), antirheumatic drugs in 7 cases (6.7%), digestive agents in 7 cases (6.7%), psychotropic drugs in 5 cases (4.8%) and endocrine drugs in 2 cases (1.9%); in 17 patients with DILI having liver biopsies, the liver histopathological examination showed hepatocyte balloon degeneration in 11 cases (64.7%), punctate necrosis in 10 cases (58.8%), bridging necrosis in 4 cases (23.5%), inflammatory cell infiltration in portal area in 15 cases (88.2%), intrahepatocyte cholestasis or bile embolus formation in 5 cases (29.4%), and hepatocyte rose knot in 1 case (5.9%); the incidences of blood hypertension and hyperlipoidemia in patients with DILI were 17.3% and 34.6%, muchhigher than 8.1% and 18.2% (P<0.05) in patients without DILI; serum ALT, AST, GGT, ALP, bilirubin, TG and TC levels in patients with DILI increased greatly in our series; the univariate Logistic analysis showed that the hyperlipoidemia [OR=2.17, 95%CI(1.39-3.40), P=0.001] was the independent factor for the happening of DILI; out of the 104 patients with DILI, it was found that the severity of liver injury ≤grade 2 in 80 cases, and ≥grade 3 in 24 cases; the multivariate Logistic analysis demonstrated that the hyperlipoidemia [OR=3.10, 95%CI(1.34-7.11)] and the period of medicine administered [OR=0.26, 95%CI(0.08-0.80)] were the independent risk factors for the severity of liver injury (P<0.05). Conclusion The common causative medicines for DILI in a general hospital in China are Chinese herbal medicines, antibiotics and non-steroidal anti-inflammatory drugs, and the patients with multi-systemic underlying diseases and hyperlipoidemia are prone to having DILI, which should be carefully dealt with in clinical practice.

Key words: Drug-induced liver injury, Chinese herbal medicines, Antibiotics, Hyperlipoidemia, Multivariate Logistic analysis