Analysis of factors affecting long-term prognosis of patients with drug-induced liver injury

Abstract

Abstract: Objective To analyze the clinical data of patients with drug-induced liver injury (DILI) and explore the prognostic factors of DILI patients.Methods A total of 126 patients with DILI in hospital from January 2016 to June 2020 were selected. The diagnosis of DILI was in accordance with the guidelines for the diagnosis and treatment of DILI. According to the condition, the patients were divided into remission group and uncured group. The measurement data were expressed as (±s) and analyzed by t-test, count data were expressed as (%) and chi-square test was used, univariate and multivariate Logistic regression analysis were performed to determine the independent predictive factors affecting the prognosis of patients with DILI.Results Of the 126 patients with DILI, 92 patients were treated with remission (remission group) and 34 patients with uncured treatment (uncured group). Univariate analysis of the clinical data of patients in remission group and uncured group showed that the age of remission group was (43.7±9.6) years, and that of uncured group was (51.6±10.3) years. There was significant difference between the two groups (Z=5.192, P<0.05). The ALT, AST and INR in remission group were (94.2±40.5) u/l, (108.8±35.2) u/l and (1.9±1.1), which were significantly lower than those in uncured group [(350.4±204.8) u/l, (320.1±92.1) and (1.2±0.3), Z=14.829、12.028、10.914,P<0.05]. In the remission group, there were 66 cases of western medicine (71.7%), 9 cases of traditional Chinese medicine / proprietary Chinese medicine (9.8%), 17 cases of combined use (18.5%). And in the uncured group, there were 14 cases of western medicine (41.2%), 8 cases of traditional Chinese medicine / proprietary Chinese medicine (23.5%) and 12 cases of combined use (35.3%). The difference was statistically significant (Z=26.278, P< 0.05). Age, ALT, AST, INR and the type of drugs were set as independent variables, and the prognostic status of patients with DILI was set as dependent variables (assignment 0 = remission, 1 = not cured). The results of multivariate analysis showed that INR and the type of drugs were independent predictors of prognosis in patients with DILI.Conclusion INR and the type of drugs are independent predictive factors affecting the prognosis of patients with DILI. In the process of clinical drug use, attention should be paid to the use of type of drugs.

Key words: Drug-induced liver injury, Prognosis, Logistic regression analysis

CAI Tao, SUN Lan-zhen, LAN Xiao-hong. Analysis of factors affecting long-term prognosis of patients with drug-induced liver injury[J]. Chinese Hepatolgy, 2021, 26(6): 674-676.

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