New progress in the epidemiological study of drug-based liver injury in China
Last Update: 2020-06-17
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Drug-induced liver injury is one of the most important causes of unexplained liver injury encountered in China," and it is also one of the most common causes of acute liver injuryBecause of the lack of specific clinical manifestations of drug-induced liver injury and diagnostic markers, especially the incidence of chronic liver injury caused by drugs is more hidden, so clinically often can not be detected or diagnosedaccording to statistics, in the general population in Western countries, the annual incidence of DILI is 1/100,000 to 200,000 peopleTHE ANNUAL INCIDENCE OF DILI IN FRANCE AND ICELAND IS APPROXIMATELY 13.9 PER 100,000 AND 191 PER 100,000, RESPECTIVELY, AND IN THE UNITED STATES IT IS APPROXIMATELY 2.7 PER 100,000China's drug-based liver injury multi-center retrospective epidemiological cohort study lasted for 3 years, including 25927 cases of DILI patients in 308 hospitalsThe study showed the main suspect drugs (including Western medicine, traditional Chinese medicine, herbal medicine, etc.) in Chinese groups, as well as clinical characteristics, treatment status, etcThe results showed that most cases of DILI were liver cell damage (51.39%), followed by mixed damage (28.30%) and bile siltation (20.31%)In China, the most important drugs causing liver damage are various health products and traditional Chinese medicine (26.81%), anti-tuberculosis drugs (21.99%), anti-tumor drugs or immunomodulators (8.34%)The study also found that 13 percent of patients were chronic drug liver damage, and 23.38 percent combined with viral hepatitis, fatty liver and other basic liver diseases when DILI occurredAlthough 44.4% of patients with hepatocellular impairment met Hey's law, only 280 patients (1.08%) progressed into liver failure, 2 patients received liver transplants (0.01%) and 102 patients died (0.39%) and 72 patients (70.59%) died mainly from DILI, which contributed to the deaths of 21 patients (20.59%) and 9 (8.82%) had nothing to do with DILI, represented by the 66 centres that completed the DILI assessment, it is estimated that the annual incidence rate of DILI in the general population of our country is about 23.80 per 100,000, but the figure is based on conservative estimates of hospital inpatients, and the study does not include outpatient and untreated patients, so the actual incidence should be higher than this figurethe incidence of DILI in China is higher than foreign countries, on the one hand may be related to the disease spectrum characteristics of the population of our country, such as tuberculosis and tumor is a high incidence of diseasein, which also means that more patients need to receive anti-TB drugs and anti-tumor drugs treatment, and these drugs can increase the risk of occurrence of DILI;Western medicine can cause liver damage, the public awareness is relatively high, but also pay more attention to the drug will be regularly monitored, once the liver injury, will usually take the initiative to report to the doctorAnd health care products, people often think that beneficial harmless, Chinese medicine is often considered no adverse reactions, therefore, clinically once liver damage, very few patients actively report to the doctor health care products and the application history of Traditional Chinese medicine, resulting in health products and Chinese medicine caused by liver damage is underestimated or even ignoredHowever, this is a misunderstanding of cognition, the public should understand this information, health care products and Chinese medicine, like Western medicine, may also cause liver damage, improve awareness in this regard will help to better monitor and prevent the occurrence of liver damageonce liver damage occurs, timely discontinuation of suspicious drugs is the key to treatment, followed by the repair of the damaged liver cell membraneThe hydrophilic-phospholipid complex is a commonly used anti-inflammatory liver treatment drug By binding to liver cell membrane protein, the hydrophilic-phospholipid complex can stabilize the liver cell membrane and protect the liver enzyme system, capture the free oxygen radicals in the liver cells, prevent the mitochondria from being oxidized, prevent the oxidation of the damaged protein, inhibit the release of the hyperoxyionion ions of neutrophil cells, play an antioxidant role, and can reduce a variety of front Inflammatory factor levels to achieve anti-inflammatory effects, through antioxidant and direct suppression of the activation of various cytokines to the liver star cells, to achieve anti-fibrosis, can reduce the liver triglycerides (TG) content and serum TG, total cholesterol (TCh) levels, and improve the liver fat and balloon-like change.
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