Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, Shanghai, China.
Liver Int. 2022 Aug;42(9):1999-2014. doi: 10.1111/liv.15262. Epub 2022 Apr 2.
The epidemiology and aetiology of drug-induced liver injury (DILI) vary across different countries and populations. Overall, DILI is rare in the general population but has become more prevalent in hospitalized patients, especially among patients with unexplained liver conditions. In addition, drugs implicated in DILI differ between Western and Eastern countries. Antibiotics are the leading drugs implicated in DILI in the West, whereas traditional Chinese medicine is the primary cause implicated in DILI in the East. The incidence of herbal and dietary supplements-induced hepatotoxicity is increasing globally. Several genetic and nongenetic risk factors associated with DILI have been described in the literature; however, there are no confirmed risk factors for all-cause DILI. Some factors may contribute to the risk of DILI in a drug-specific manner.
药物性肝损伤(DILI)的流行病学和病因在不同国家和人群中有所不同。总体而言,DILI 在普通人群中较为罕见,但在住院患者中更为普遍,尤其是在不明原因肝损伤患者中。此外,DILI 涉及的药物在西方国家和东方国家之间也有所不同。在西方国家,抗生素是导致 DILI 的主要药物,而在东方国家,中药是导致 DILI 的主要原因。全球范围内,草药和膳食补充剂引起的肝毒性的发病率正在上升。文献中已经描述了与 DILI 相关的一些遗传和非遗传危险因素;然而,并非所有原因引起的 DILI 都有明确的危险因素。一些因素可能以药物特异性的方式导致 DILI 的风险增加。