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High risk factors associated with relapse of chronic drug-induced liver injury
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Ya Deng1, 2, Chun-Yan Wang2, Wen-Hui Tan1, 2, Yi-Ming Fu2, Song-Hai Chen2, Zhong-Bin Li2, Guo-Feng Chen2, Dong Ji1, 2, *
Medical Journal of Chinese People’s Liberation Army | 2021, 46(9) : 928 - 934
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Medical Journal of Chinese People’s Liberation Army | 2021, 46(9): 928-934
• Clinical Research •
High risk factors associated with relapse of chronic drug-induced liver injury
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Ya Deng1, 2, Chun-Yan Wang2, Wen-Hui Tan1, 2, Yi-Ming Fu2, Song-Hai Chen2, Zhong-Bin Li2, Guo-Feng Chen2, Dong Ji1, 2, *
Affiliations
  • 1Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
  • 2Senior Department of Hepatology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
Published: 2021-09-28 doi: 10.11855/j.issn.0577-7402.2021.09.14
Outline
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Objective To explore the high-risk factors associated with relapse of chronic drug-induced liver injury(DILI) to provide a basis for accurate prediction and treatment. Methods The clinical data of 1660 patients with chronic DILI patients, who were hospitalized from January 2012 to June 2017, were retrospectively collected. The average age of the patients was(43.9±12.3) years old and 970 were females. And they were divided into relapse group (n=196) and non-relapse group (n=1464).Spearman rank correlation was used to analyze the association of inflammation degree and fibrosis stage with relapse, while the high-risk factors associated with relapse were analyzed by univariable and multivariable logistic regression. Results With the increase in the degree of inflammation and fibrosis, the proportion of patients with relapse increased [inflammation grade (G0: 0%, G1: 0.9%, G2:5.8%, G3: 50.7%, G4: 72.7%), fibrosis stage (S0: 2.8%, S1: 5.0%, S2: 17.1%, S3: 22.4%, S4: 42.7%), P<0.001]. Spearman rank correlation analysis showed inflammation grade (r=0.463) and fibrosis stage (r=0.275) had a positive correlation with relapse. Especially,inflammation grade ≥G3 (OR=5.75, 95%CI 3.83-8.64, P<0.001) is a high-risk factor associated with relapse in chronic DILI patients. Biochemically, multivariable logistic regression analysis showed that age >60 years (OR=2.14, 95%CI 1.17-3.90, P=0.014),AST >2×ULN (OR=3.62, 95%CI 1.64-7.79, P=0.001), TBIL >2×ULN (OR=2.19, 95%CI 1.39-3.44, P=0.001), CHE <1×ULN(OR=3.42, 95%CI 2.34-5.01, P<00.01), PLT <100×109/L (OR=2.09, 95%CI 1.24-3.54, P=0.006) were independent high-risk predictors associated with relapse. Conclusion Older age, high AST and TBIL, low CHE and PLT, inflammation grade ≥G3 are high risk factors for relapse, which are of great clinical significance for early prediction and effective improvement of chronic DILI outcome.

chronic drug-induced liver injury  /  relapse  /  high-risk factors
Ya Deng, Chun-Yan Wang, Wen-Hui Tan, Yi-Ming Fu, Song-Hai Chen, Zhong-Bin Li, Guo-Feng Chen, Dong Ji. High risk factors associated with relapse of chronic drug-induced liver injury[J]. Medical Journal of Chinese People’s Liberation Army, 2021 , 46 (9) : 928 -934 . DOI: 10.11855/j.issn.0577-7402.2021.09.14
Funding
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  • Capital Characteristic Clinic Project of Beijing Municipal Science and Technology Commission(Z181100001718034)
  • Key Project of Jumei Special Fund for Hepatobiliary Disease Prevention and Treatment(2018JM12603003)
Appendix
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Year 2021 volume 46 Issue 9
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Article Info
doi: 10.11855/j.issn.0577-7402.2021.09.14
  • Receive Date：2020-12-27
  • Online Date：2025-12-19
  • Published：2021-09-28
Article Data
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History
  • Received：2020-12-27
  • Revised：2021-06-22
Funding
Capital Characteristic Clinic Project of Beijing Municipal Science and Technology Commission(Z181100001718034)
Key Project of Jumei Special Fund for Hepatobiliary Disease Prevention and Treatment(2018JM12603003)
Affiliations
    1Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, China
    2Senior Department of Hepatology, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China

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