本研究旨在评估HILI患者预先存在的慢性肝病(CLD)的并发与预后较差之间的关联。
病例对照研究.
中国肝病专科医院.
通过比较2007年2月至2017年1月有或没有先前存在的CLD的HILI,对145例住院的HILI患者的预后进行了评估。25例先前存在酒精性肝病(ALD)或非酒精性脂肪性肝病(NAFLD)的HILI病例和200例ALD或NAFLD对照性别匹配1:8,年龄(±4岁),体重指数(±2kg/m2),CLD的类型,酒精摄入量(±5g/d)和是否存在肝硬化。
有或没有预先存在的CLD的HILI患者的死亡率和慢性,和匹配的CLD患者。
在193714例肝病住院患者中,5703例患者符合药物性肝损伤(DILI)的诊断标准,这归因于何首乌。(PMT)145例。在这些HILI患者中,22.8%(145个中的33个)有预先存在的CLD,包括17(51.5%)使用ALD,8(24.2%)与NAFLD,5例(15.2%)合并慢性病毒性肝炎和3例(9.1%)合并自身免疫性肝病。与无CLD的HILI患者相比,先前存在CLD的HILI患者的死亡率更高(0.9%vs9.1%,p=0.037)和更高的慢性性(12.5%对30.3%,p=0.016)。与匹配的ALD(136例)或NAFLD(64例)患者相比,先前存在ALD的HILI患者表现出更高的慢性性(35.3%vs11.8%,p=0.019)。多因素logistic回归分析发现,同时存在CLD是慢性和死亡率的独立危险因素(OR3.966,95%CI1.501至10.477,p=0.005)。尤其是慢性性(OR3.035,95%CI1.115至8.259,p=0.030)。
先前存在的CLD的并发可能是预后较差的独立危险因素,尤其是慢性,在与PMT相关的HILI中。
The present study aimed to evaluate the association between the concurrence of pre-existing chronic liver diseases (CLD) and worse prognosis in patients with HILI.
A
case-control study.
Tertiary hospital specialising in liver diseases in China.
145 hospitalised HILI patients were assessed with respect to prognosis by comparing HILI with or without pre-existing CLD from February 2007 to January 2017. Twenty-five HILI cases with pre-existing alcoholic liver disease (ALD) or non-alcoholic fatty liver disease (NAFLD) and 200 ALD or NAFLD controls matched 1:8 for sex, age (±4 years old), body mass index (±2 kg/m2), the type of CLD, alcohol intake (±5 g/d) and the presence or absence of cirrhosis.
Mortality and chronicity in HILI patients with or without pre-existing CLD, and matched CLD patients.
Of the 193 714 hospitalised patients with liver diseases, 5703 patients met the diagnostic criteria for drug-induced liver injury (DILI), which was attributed to Polygonum multiflorum Thunb. (PMT) in 145 patients. Among these HILI patients, 22.8% (33 of 145) had pre-existing CLD, including 17 (51.5%) with ALD, 8 (24.2%) with NAFLD, 5 (15.2%) with chronic viral hepatitis and 3 (9.1%) with autoimmune liver disease. Compared with HILI patients without CLD, HILI patients with pre-existing CLD showed higher mortality (0.9% vs 9.1%, p=0.037) and higher chronicity (12.5% vs 30.3%, p=0.016). Compared with matched ALD (136 patients) or NAFLD (64 patients) patients, HILI patients with pre-existing ALD showed higher chronicity (35.3% vs 11.8%, p=0.019). Multivariate logistic regression analysis found that concurrence of pre-existing CLD was an independent risk factor for both of chronicity and mortality (OR 3.966, 95% CI 1.501 to 10.477, p=0.005), especially the chronicity (OR 3.035, 95% CI 1.115 to 8.259, p=0.030).
Concurrence of pre-existing CLD could be an independent risk factor for worse prognosis, especially chronicity, in PMT-related HILI.