Department of Hepatology, The First Hospital of Jilin University, Jilin University, No. 71 Xinmin Street, Changchun, 130021, China.
Key Laboratory of Organ Regeneration and Transplantation of Ministry of Education, The First Hospital of Jilin University, Changchun, 130061, People's Republic of China.
Sci Rep. 2021 Jan 12;11(1):773. doi: 10.1038/s41598-020-80116-4.
We used a retrospective study design to evaluated the predictive value of red cell distribution width (RDW) for drug-induced liver injury (DILI) severity in Chinese patients with liver biopsy to assist with early DILI management. We included 164 DILI patients with complete laboratory information and medical history. We compared outcomes of 36 patients with severe DILI with outcomes of a control group of 128 patients with mild-to-moderate DILI. Multivariate analyses of risk factors for severe liver injury in Chinese patients with DILI revealed an estimated adjusted odds ratio (AOR) (95% CI) of 4.938 (1.088-22.412) in patients with drinking. Risk for serious liver injury was also increased significantly in patients with dyslipidemia [AOR (95% CI) 3.926 (1.282-12.026)], higher serum total bile acid (TBA) levels [AOR (95% CI) 1.014 (1.009-1.020)] and higher RDW [AOR (95% CI) 1.582 (1.261-1.986)]. The result for area under the curve of 0.905 for TBA levels indicated this variable had high diagnostic performance for predicting DILI severity. Based on an area under the curve value of 0.855, RDW also had superior diagnostic performance in prediction of DILI severity. This performance was not significantly different compared with TBA and was superior compared with other variables, which had area under values ranging from poor to failure (0.527-0.714).The risk for severe DILI was associated with drinking, dyslipidemia, higher TBA levels and RDW values. This study found that RDW and TBA levels were predictors of DILI severity in Chinese patients.
我们采用回顾性研究设计，评估红细胞分布宽度（RDW）对中国肝活检患者药物性肝损伤（DILI）严重程度的预测价值，以协助早期 DILI 管理。我们纳入了 164 例具有完整实验室信息和病史的 DILI 患者。我们比较了 36 例严重 DILI 患者的结局与 128 例轻度至中度 DILI 对照组的结局。多因素分析中国 DILI 患者严重肝损伤的危险因素显示，饮酒患者的严重肝损伤调整后比值比（AOR）（95%CI）为 4.938（1.088-22.412）。血脂异常患者严重肝损伤的风险也显著增加[比值比（95%CI）3.926（1.282-12.026）]，总胆汁酸（TBA）水平较高[比值比（95%CI）1.014（1.009-1.020）]和 RDW 较高[比值比（95%CI）1.582（1.261-1.986）]。TBA 水平曲线下面积为 0.905，表明该变量对预测 DILI 严重程度具有较高的诊断性能。基于曲线下面积值 0.855，RDW 在预测 DILI 严重程度方面也具有优越的诊断性能。与 TBA 相比，这种性能没有显著差异，与其他变量相比，具有从差到失败的面积值范围（0.527-0.714）。严重 DILI 的风险与饮酒、血脂异常、较高的 TBA 水平和 RDW 值有关。本研究发现，RDW 和 TBA 水平是中国患者 DILI 严重程度的预测指标。
