Objective To explore the clinical features and pathological changes in patients with drug-in-duced liver injury (DILI) in recent years. Methods Data of 441 patients with DILI from January 2010 to May 2014,including the medication courses,clinical manifestations, lab results,pathological findings and disease courses, were retrospectively analyzed. Results The numbers of patients with traditional Chinese medicine (TCM)-induced liver injury and western medicine-induced liver injury were 176 (39.91%) and 210 (47.62%),respectively;All patients were divided into three clinical types:e.g. 178(40.36%) with hepatocyte DILI,132(29.93%) with cholestatic DILI and 131(29.71%) with mixed DILI;No significant difference was found in histological changes and laboratory indexes between TCM-and western medicine-induced liver injuries (P>0.05);However,TCM-induced patients had a lower incidences of erythra than in patients receiving western medicine (1.1% vs. 5.2%,P<0.05),but had a higher incidences of splenomegaly(78.4% vs. 46.2%,P<0.05);In addition,it took longer to develop liver injuries for TCM-induced patients(P<0.05);The recovery rate of all the DILI patients in this series was 94.56%. Conclusion A variety of medicines is closely involved in reducing DILI in clinical practice,which warrants further studies.%目的 分析近年来药物性肝损伤患者的临床特点和肝组织病理学特征.方法 收集2010年1月1日至2014年5月收治的441例药物性肝损伤患者的用药特点和时间、临床表现、实验室检查、病理活检及临床病程等资料,进行回顾性分析.结果 中(草)药和西药所致肝损伤分别为176例(39.91%)和210例(47.62%),其它原因致肝损伤为55例(12.47%);从临床分型看,肝细胞型178例(40.36%),其次是胆汁淤积型132例(29.93%)和混合型131例(29.71%);中药和西药所致药物性肝损伤在病理类型和实验室检查方面无显著性差异(P>0.05);在临床症状方面,中药发生皮疹的比例显著低于西药(1.1%对5.2%,P<0.05),而脾脏肿大比例显著高于西药(78.4%对46.2%, P<0.05);中药诱发肝损伤相对西药用药时间较长(P<0.05);本组总体治愈好转率为94.56%.结论 药物性肝损伤的发生与多种药物及用药时间密切相关.
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