CIOMS /RUCAM Maria 113 BMI ± % % AIH F P = Maria

1058 J Clini Hepatol October 2011 Vol. 27 No. 10 / 113 200025 CIOMS /RUCAM Maria 2008 7 ~ 2010 11 113 BMI 113 77 36 47. 73 ± 13. 17 48. 67% 47. 79% 44. 25% 1 AIH F P = 0. 015 HAI 9 F 4 6. 19% 42. 86% CIOMS /RUCAM 6 77. 88% Maria 10 60. 18% AIH HAI 9 F 4 CIOMS /RUCAM Maria RUCAM Maria R575 A 1001-5256 2011 10-1058 - 05 The analysis of clinical features and risk factors in 113 patients with drug - induced liver injury DAI Wei - jia LAI Rong - tao WANG Hui et al. Department of Infection Ruiijin Hospital Shanghai Jiaotong University School of Medicine Shanghai 200025 China Abstract Objectives To analyze the clinical manifestation and influencing factors of drug - induced liver injury DILI and to compare the accuracy of two diagnostic criteria CIOMS / RUCAM and Maria score. Methods Retrospective analysis was performed on 113 patients who have been diagnosed as drug - induced liver injury by liver biopsy in Ruijin hospital between July 2008 and November 2010. Age sex BMI serological indicators liver biopsy histologic changes causes clinical manifestation and prognoses were recorded. Results Among the 113 patients 77 patients were female and 36 patients were male. The average age was 47. 73 ± 13. 17. Chinese herbal medicine and diet tea were the main causes of DILI 48. 67% followed by antibiotics antipyretic analgesic anti - inflammatory drugs and cardiovascular drugs. The main symptoms were asthenia nausea and epigastric discomfort. Classification 47. 79% of the patients were the injury type of hepatocytes and most of them were female. The rest were the type of cholestasis and mix type. 44. 25% of the patients reached to normal liver function after 1 month treatment. Ishak fibrosis score F of the patients with the complication - AIH was high P = 0. 015. There were 7 cases 6. 19% falling into both histological activity index HAI 9 and F 4 and 42. 86% of them kept the liver function abnormal o- ver half a year or died. CIOMS /RUCAM score 6 and Maria score 10 were 77. 88% and 60. 18% respectively. Conclusion Chinese herbal medicine and diet tea were the main causes of DILI. Most of patients reinstated well after abandoning the medicine. Most of the hepatocytes type were female. The complication - AIH would influence over Ishak fibrosis score. Patients with HAI 9 and F 4 had poor prognosis. The sensitivity of RUCAM score was higher than Maria score. Key words hepatitis toxic RUCAM score Maria score 2011-09 - 13 2011-09 - 30 No 81070334 No 10411966800 1986 - E-mail wanghuirjrj@ yahoo. com. cn drug - induced liver injury DILI

1059 113 31. 86% 36 / 113 CIOMS / 50. 65% 36. 11% RUCAM 1 Maria 2 ALT P = 0. 874 1 1. 1 113 2008 7 ~ 2010 11 >0. 05 χ 2 = 0. 522 P > 0. 05 77 36 17 χ 2 = 1. 475 P > 0. 05 χ 2 = ~ 84 47. 73 ± 13. 17 1. 908 P > 0. 05 χ 2 = 0. 375 P > 0. 05 χ 2 = 0. 006 P > 0. 05 AIH 2. 1. 3 AIH CHB CHC 1. 2 6. 19% 7/ 113 CHB 7. 96% 9/ 113 CHC 1. 77% 2/ 113 AIH F P = 1. 3 2. 2 B 16G 1 s 1 1 cm 4 1 4% - 2. 3 53. 98% 61 /113 42. 48% 48 / 113 27. 43% 31 /113 15. 04% 17 /113 7. 96% 9 /113 0. 88% HAI Ishak 3 1. 4 SPSS11. 0 18. 69% 21 /113 x ± s t 5. 31% 6 /113 Kruskal - 2. 4 Wallis P < 0. 05 113 ALT 3 ULN 2 ALT/ULN / ALP/ULN 5 47. 79% 54/113 2. 1 ALP 2 ULN ALT/ ULN / ALP/ULN 2 2. 1. 1 113 17 ~ 84 15. 04% 17/113 ALT 3 ULN ALP 2 10 ULN 2 < ALT/ULN / ALP/ULN < 5 23. 01% 26/ 10 ~ 20 21 ~ 30 31 ~ 40 41 ~ 50 51 ~ 60 61 ~ 70 71 ~ 80 81 ~ 90 8 Kruskal - Wallis 25. 93% 14/54 ALT P = 0. 441 2. 5 44. 25% RUCAM 55 50/113 1 13. 27% t ALT P = 0. 498 ALT 7. 08% 8/113 3 P = 0. 938 2. 1. 2 68. 14% 77 / χ 2 = 0. 044 P 15. 93% 18/113 AIH 0. 015 AIH 1 /113 11. 50% 13 /113 113 14. 16% 16/113 74. 07% 40/54 15/113 2 6. 19% 7/113 2

1060 J Clini Hepatol October 2011 Vol. 27 No. 10 1 16 14. 16% 5 4. 42% 1 3 5 2 7 6 5. 31% 3 2 55 48. 67% 2 2 1 0. 88% 1 0. 88% 13 11. 50% 1 1 2 1. 77% 7 2 3 1 0. 88% 2 1 9 7. 96% / 4 3. 54% 2 3 3 1 4 HAI 9 F 4 7 t ALT 42. 86% 3/7 P 1 = 0. 337 P 2 = 0. 757 χ 2 =6. 97 P <0. 01 P = 0. 893 RUCAM P = 0. 843 Maria P = 0. 382 2. 6 DILI 3 Ⅲ Kupffer 113 1 2 3 4 HAI 9 18. 58% 21 / 113 F 4 15. 04% 17 / 113 HAI 9 9. 73% 11 / 113 F 4 2. 7 P = 0. 186 P = 0. 164 Ishak RUCAM < 6 22. 12% 25 /113 Maria P = 0. 677 F P = 0. 623 < 10 39. 82% 45 /113 SPSS Maria 95% 15. 01 ~ 15. 53 RUCAM 95% 7. 92 ~ 8. 37 5 6 HAI 9 21 5 52. 38% 11/21 2 9. 6. 52% 2/ 21 1 3% 5 / 113 F 4 17 35. 29% 6/17 2 23. 53% 4/ 17 11. 4%

1061 2 x ± s ALT U /L 609 ± 632. 6 310 ± 877. 0 428 ± 502. 4 920 ± 609. 0 839 ± 484. 4 489. 5 ± 875. 5 1 224. 5 ± 425. 4 268. 5 ± 334. 8 238 ± 222. 8 205. 5 ± 530. 6 621 ± 346. 3 299 ± 112. 9 2 152. 5 ± 209. 9 133 ± 82. 0 95 ± 75. 6 104 ± 145. 3 251. 5 ± 110. 1 164 ± 90. 3 4 92 ± 118. 1 63 ± 93. 5 47 ± 28. 0 57 ± 36. 0 105 ± 46. 7 124. 5 ± 59. 1 8 42 ± 39. 8 40 ± 53. 6 16 ± 9. 1 48 ± 80. 0 64 ± 31. 1 48 ± 143. 7 AST U /L 399. 5 ± 383. 6 252 ± 556. 6 254 ± 337. 4 493. 5 ± 394. 3 181 ± 338. 7 346. 5 ± 455. 0 1 195 ± 269. 7 169. 5 ± 95. 8 153 ± 230. 0 129. 5 ± 179. 4 263 ± 120. 9 107 ± 273. 0 2 77 ± 188. 1 66 ± 115. 3 94 ± 59. 3 85 ± 39. 0 97 ± 20. 3 73 ± 53. 3 4 46 ± 178. 0 42 ± 149. 2 59 ± 20. 2 37 ± 22. 1 68 ± 31. 1 55 ± 32. 6 8 36 ± 44. 1 35 ± 48. 1 20 ± 11. 6 31 ± 46. 7 32. 5 ± 12. 0 29 ± 80. 4 ALP U /L 163 ± 120. 4 176. 5 ± 305. 7 217 ± 214. 6 208. 3 ± 42. 0 101 ± 24. 4 161 ± 68. 4 1 135 ± 66. 1 165. 5 ± 132. 7 160. 5 ± 304. 9 107 ± 32. 7 115 ± 30. 4 129 ± 49. 1 2 106 ± 45. 8 137 ± 113. 3 152 ± 299. 1 105 ± 24. 3 95. 5 ± 28. 7 109 ± 34. 0 4 107 ± 48. 0 136 ± 68. 2 154 ± 166. 5 96. 5 ± 30. 6 82 ± 2. 9 83 ± 15. 5 8 98. 5 ± 51. 6 147 ± 47. 9 95. 5 ± 23. 2 69 ± 19. 8 65 ± 11. 3 68 ± 10. 8 GGT U /L 191 ± 200. 7 139 ± 523. 0 178 ± 372. 6 260. 7 ± 291. 3 265 ± 286. 9 186 ± 175. 3 1 140 ± 114. 9 250 ± 344. 8 107 ± 238. 7 220. 5 ± 188. 8 100 ± 135. 0 202 ± 207. 1 2 135 ± 91. 8 175 ± 212. 1 82 ± 192. 3 178 ± 122. 8 144. 5 ± 127. 5 179. 5 ± 168. 7 4 101 ± 162. 6 146 ± 117. 3 65 ± 92. 4 171 ± 31. 7 157 ± 74. 9 61 ± 78. 5 8 89 ± 141. 4 155 ± 90. 8 36. 5 ± 20. 4 85 ± 17. 9 47 ± 1. 4 61 ± 86. 2 TBil μmol /L 47. 9 ± 71. 5 65. 9 ± 97. 7 93. 4 ± 75. 7 112. 8 ± 49. 3 71. 3 ± 21. 8 78. 1 ± 59. 7 1 40. 9 ± 114. 8 71. 8 ± 77. 0 122. 2 ± 108. 4 58. 6 ± 57. 7 30. 7 ± 17. 9 68 ± 24. 6 2 28. 5 ± 113. 6 61. 7 ± 57. 6 198. 2 ± 137. 2 39. 0 ± 62. 8 35. 6 ± 16. 8 62. 6 ± 29. 8 4 28. 8 ± 193. 7 21. 8 ± 33. 6 129. 2 ± 117. 8 24. 6 ± 41. 7 22. 3 ± 4. 8 48. 5 ± 22. 1 8 20. 8 ± 34. 7 22. 2 ± 142. 4 44. 5 ± 20. 1 26. 9 ± 18. 9 12. 1 ± 1. 4 24. 6 ± 12. 6 ALT 10 ~ 64 U /L AST 8 ~ 40 U /L ALP 38 ~ 126 U /L GGT 7 ~ 64 U /L TBil 5. 1 ~ 20. 5 μmol /L ALT 3 ALT /ULN / ALP /ULN 5 44. 3% 57. 52% 1 ~ 2 6 HAI F AIH 6 7 50. 65% vs 36. 11% P < 0. 05 90% 8 1065

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