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药物性肝损伤发病率的研究:系统综述和荟萃分析。

Mapping the incidence of drug-induced liver injury: A systematic review and meta-analysis.

机构信息

Clinical Epidemiology and Evidence Based Medicine Unit, Beijing Friendship Hospital, Capital Medical University, Beijing Clinical Research Institute, Beijing, China.

Liver Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

出版信息

J Dig Dis. 2023 May;24(5):332-339. doi: 10.1111/1751-2980.13205. Epub 2023 Aug 13.

Abstract

OBJECTIVES

Drug-induced liver injury (DILI) is an increasing etiology of liver dysfunction, with various incidence worldwide. To better understand the disease burden and establish appropriate preventive and treatment strategies, a systematic review and meta-analysis was conducted.

METHODS

PubMed, EMBASE, Web of Science, and Cochrane Library were searched for studies on the incidence of DILI published up to June 1, 2022. According to the predefined criteria, only population-based studies were included. Incidence was presented as cases per 100 000 person-years with 95% confidence interval (CI) using a random-effects model.

RESULTS

A total of 14 studies were included. The overall incidence of DILI was 4.94 per 100 000 person-years (95% CI 4.05-5.83). Time-based cumulative meta-analysis suggested that the incidence of DILI increased over time since 2010. The incidence varied by regions, with Asia having the highest incidence of 17.82 per 100 000 person-years (95% CI 6.26-29.38), while North America having the lowest incidence of 1.72 per 100 000 person-years (95% CI 0.48-2.95). All studies reported a higher incidence of DILI in the elderly but comparable incidences between male and female (3.42 per 100 000 person-years vs 4.64 per 100 000 person-years).

CONCLUSIONS

The global incidence of DILI has been increasing since 2010, with the highest incidence in Asia. Understanding the epidemiological characteristics of DILI helps establish specific strategies to deal with this emerging health problems.

摘要

目的

药物性肝损伤(DILI)是一种日益常见的肝功能障碍病因,全球各地的发病率各不相同。为了更好地了解疾病负担并制定适当的预防和治疗策略,进行了系统评价和荟萃分析。

方法

检索了截至 2022 年 6 月 1 日发表的关于 DILI 发病率的 PubMed、EMBASE、Web of Science 和 Cochrane Library 研究。根据预设标准,仅纳入基于人群的研究。发病率以每 10 万人年的病例数表示,采用随机效应模型给出 95%置信区间(CI)。

结果

共纳入 14 项研究。DILI 的总体发病率为 4.94 例/10 万人年(95%CI:4.05-5.83)。基于时间的累积荟萃分析表明,自 2010 年以来,DILI 的发病率呈上升趋势。发病率因地区而异,亚洲的发病率最高,为 17.82 例/10 万人年(95%CI:6.26-29.38),而北美的发病率最低,为 1.72 例/10 万人年(95%CI:0.48-2.95)。所有研究均报告老年人 DILI 发病率较高,但男女发病率相当(3.42 例/10 万人年比 4.64 例/10 万人年)。

结论

自 2010 年以来,全球 DILI 的发病率一直在上升,亚洲的发病率最高。了解 DILI 的流行病学特征有助于制定针对这一新兴健康问题的具体策略。

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