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Research on the Clinical Characteristics and the Prognostic Influencing Factors of the Drug-induced Liver Injury

Author: QiuLing
Tutor: HuYuLin
School: Jilin University
Course: Clinical
Keywords: drug-induced liver injury liver toxicity clinical feature diagnostic criteria prognosis
CLC: R595.3
Type: Master's thesis
Year: 2012
Downloads: 201
Quote: 0
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Drug-induced liver injury (DILI) refers to the drugs during treatment due to drug or itsmetabolites cause hepatotoxicity damage or liver of drugs and metabolites of the allergicreactions caused by disease, also known as for drug-induced hepatitis. With an agingpopulation, a large number of R&D of new drugs and the increase in many types ofmedication, drug-induced liver injury is a common clinical liver disease. The disease canoccur not only in patients without liver disease can also occur in patients with liver diseaseor other diseases. However, many types of drugs cause drug-induced liver injury, diseaseclinical symptoms and laboratory tests there was no specificity, no valid diagnostic criteria,so the disease there are a lot of misdiagnosis and missed diagnosis, especially in the mergerof chronic liver disease or patients with other chronic disease. Although the majority of theprognosis of the disease better, but there are also cases of liver failure, and even lead to death.Therefore, the summary and the clinical features of drug-induced liver injury and itsinfluencing factors have important clinical implications for clinical treatment, to reduce theoccurrence and development of drug-induced liver injury.According to statistic, the drugs cause drug-induced liver injury are about1100species,involving almost every class of drugs of current research and development. Common drugsin recent years led to drug-induced liver injury in Chinese medicine. Anti-TB drugs, andantineoplastic agents. Is generally believed that the predictability of drug-induced liverinjury in a significant dose-dependent manner, rather than the predictability of drug-inducedliver injury is generally dose-related. Drug-induced liver injury generally occurs in5—90days of the medication, but research has shown that a long course of medication can causechronic liver damage and even cirrhosis. In addition, it is generally believed that women, theelderly, associated with chronic disease were more prone to drug-induced liver injury.Drug-induced liver injury in clinical manifestations, laboratory tests and pathologicalchange nonspecific, viral hepatitis and autoimmune liver disease, by simply relying on theclinical features of the diagnosis of drug-induced liver injury cannot be clear. At present,clinical diagnosis of drug-induced liver injury in the use of exclusion and score. Morecommonly used scoring table the law RUCAM program and Maria standard. The dualdiagnosis can be a good diagnosis of drug-induced liver injury, but the diagnostic is lagging behind, further improvement of the scoring project or the diagnostic criteria for earlier hintsof drug-induced liver injury occurs.Better the prognosis of the majority of drug-induced liver injury, but also a smallnumber of patients with liver failure and death. Timely disable liver damage drugs is the keyto the treatment of the disease, another appropriate protective and symptomatic andsupportive treatment can effectively reduced the occurrence of liver failure and death. Age,clinical type, and comorbidities, and other factors and prognosis of patients with a clearcorrelation between the onset, peak conventional coagulation and liver function goodpredictor of the prognosis of patients to assess the above-mentioned impact of drug-inducedliver injury prognostic factors, appropriate to take active treatment and preventive measuresto avoid acute liver failure and death.In our study, in January2009to December2011,394cases of inpatient drug-inducedliver injury in patients to further explore the cause of drug-induced liver injury, clinicalfeatures, diagnosis, and prognostic factors for clinical diagnosis and treatment reference.The results of this study show that: drugs causing drug-induced liver injury is mostcommon for traditional Chinese medicine, followed by multiple types of medication andanti-TB drugs; drug-induced liver injury in male and female incidence ratio was1:1.3,women slightly more than men; Drug-induced liver damage in patients with medication tothe onset of the median time of30days or so, there are differences between the various drugmedication to the pathogenesis of Median; drug-induced liver injury ages41-50years oldand51-60years of age; Current the international RUCAM program by Maria standard canbe a good guide clinical diagnosis, appropriate to reduce the diagnostic criteria, earlierdetection and diagnosis of drug-induced liver injury, drug-induced liver injury with goodprognosis, types of drug, sex of their the prognosis of no significant difference. Age, clinicaltype, and comorbidities on the prognosis of no significant difference; the onset of thecoagulation regular in the PT, the PTA, and liver function in the ALT, the ALP, albumin,TBIL, total bile acid and cholinesterase and other factors good predictor of the prognosis ofpatients.

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CLC: > Medicine, health > Internal Medicine > Systemic disease > Poisoning and chemical damage > Drug-induced diseases
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