Risk factors related to significant hepatic inflammation in patients with acute drug-induced liver injury  

作　　者：Yu-Ting Xiong Jian-Fei Wang Le Li Zhi-Fang Bai Yan Liu Ang Huang Ke-Xin Wang Yiming Fu Wucai Yang Chang Guo Mengwen He Wen-Chang Wang Chun-Yan Wang Dong Ji 

机构地区：[1]The PLA 307 Clinical College of Anhui Medical University,The Fifth Clinical Medical College of Anhui Medical University,Hefei 230032,China [2]Senior Department of Hepatology,The Fifth Medical Center of PLA General Hospital,Beijing 100039,China [3]Emergency Department,The Seventh Medical Center of PLA General Hospital,Beijing 100007,China [4]Senior Department of Infectious Diseases,The Fifth Medical Center of PLA General Hospital,Beijing 100039,China [5]Senior Department of Gastroenterology,The First Medical Center of PLA General Hospital,Beijing 100039,China [6]Peking University 302 Clinical Medical School,Beijing 100039,China [7]Chinese PLA Medical School,Beijing 100853,China

出　　处：《iLIVER》2024年第2期35-42,共8页国际肝胆健康（英文）

基　　金：supported by the Capital's Funds for Health Improvement and Research(No.2024-2-5068);the Youth Independent Innovation Project of PLA General Hospital(No.22QNCZ023);Beijing Natural Science Foundation(No.7242030);Capital Clinical Characteristic Application Research(No.Z181100001718034).

摘　　要：Background and aims:Currently,research on biopsy-proven acute drug-induced liver injury(DILI)remains limited.This study aimed to identify clinical characteristics and risk factors for significant hepatic inflammation in patients with acute DILI.Methods:An ambispective cohort study was conducted on biopsy-proven acute DILI patients admitted to our hospital from 2012 to 2018.Using the Scheuer scoring system,patients were categorized into G0-2 or G3-4 groups and followed up for 12 months after first admission.Clinical characteristics and outcomes were retrieved from medical records.Results:The median age of the 157 enrolled patients(65.6%female)was 40.4(interquartile range(IQR),31.9-49.1)years.The median latency and length of hospitalization were 30.0(IQR,5.0-60.0)and 18.0(IQR,12.0-26.0)days.The proportions of patients in the G0-2 and G3-4 groups were 54.8%and 45.2%,respectively.Logistic regression analysis revealed that females(odds ratio(OR):2.623,95%confidence interval(CI):1.169-5.887,p=0.019),higher body mass index(OR:1.168,95%CI:1.029-1.325,p=0.016),higher total bilirubin(OR:1.004,95%CI:1.000-1.007,p=0.047),and lower prothrombin activity(OR:0.976,95%CI:0,957-0.995,p=0.013)were associated with significant hepatic inflammation.The predominance of the hepatocellular injury pattern(60.5%)at admission transformed into a predominance of the cholestatic pattern(60.5%)at discharge.During follow-up,23 patients(14.6%)developed chronic DILI,with nine patients(5.7%)progressing to cirrhosis.Moreover,15 female patients(9.6%)developed autoimmunity(3cases in the G0-2 group vs 12 cases in the G3-4 group,p<0.05).Conclusion:Acute DILI patients with high-risk factors were more likely to develop significant hepatic inflammation,and females with significant inflammation were at a higher risk of developing autoimmunity during follow-up.

关 键 词：Acute drug-induced liver injury Liver biopsy Hepatic inflammation FEMALE AUTOIMMUNITY CHRONICITY 

分 类 号：R575[医药卫生—消化系统]