年龄相关的药物性肝损伤差异：2002-2022 年中国一家大型肝病专科医院的回顾性单中心研究。
Age-related differences in drug-induced liver injury: a retrospective single-center study from a large liver disease specialty hospital in China, 2002-2022.
机构信息
Department of Hepatology and Traditional Chinese Medicine, The Fifth Medical Center, PLA General Hospital, 100 West Fourth Ring Middle Road, Fengtai District, Beijing, 100039, China.
School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.
出版信息
Hepatol Int. 2024 Aug;18(4):1202-1213. doi: 10.1007/s12072-024-10679-1. Epub 2024 Jun 19.
BACKGROUND AND AIMS
Drug-induced liver injury (DILI) is a prevalent adverse reaction in clinical settings. However, there is limited research on age-related differences in DILI. We performed a large-scale retrospective study to delineate the characteristics of DILI across different age groups.
METHODS
We collected data on a total of 17,946 patients with confirmed DILI hospitalized at the Fifth Medical Center of the People's Liberation Army (PLA) General Hospital in Beijing, China, from January 1, 2002, to December 31, 2022. The patients were stratified based on age into the following groups: children (< 18 years), young adults (18-44 years), middle-aged individuals (45-64 years), and elderly individuals (≥ 65 years). We gathered demographic information, medical histories, laboratory results, disease severity assessments, and mortality statistics for all patients.
RESULTS
Overall, the distribution of DILI cases across different age groups was as follows: 6.57% were children, 24.82% were young adults, 49.06% were middle-aged individuals, and 19.54% were elderly individuals. The percentage of females increased with age, rising from 36.47% in the pediatric group to 60.51% in the elderly group. Notably, central nervous system agents (15.44%) and anti-infectious agents (21.80%) were more commonly associated with DILI in children, while cardiovascular agents (10.58%) and herbal dietary supplements or traditional medicines (H/TMs) (26.29%) were more prevalent among elderly people with DILI. Among all age groups, hepatocellular-type DILI was more common in the pediatric group (p < 0.001), whereas cholestatic-type DILI and chronic DILI were more prevalent in the elderly group (p < 0.001). Acute liver failure (ALF) and fatal outcomes were more prevalent in the pediatric and elderly groups, particularly in the pediatric group (2.04%, p = 0.041; 0.85%, p = 0.007, respectively).
CONCLUSIONS
Children and elderly individuals face a higher risk of adverse outcomes following DILI.
背景与目的
药物性肝损伤（DILI）是临床常见的不良反应。然而，年龄相关的 DILI 差异的研究有限。我们进行了一项大规模回顾性研究，以描绘不同年龄组的 DILI 特征。
方法
我们收集了 2002 年 1 月 1 日至 2022 年 12 月 31 日期间在北京解放军总医院第五医学中心住院的 17946 例确诊 DILI 患者的数据。患者按年龄分为以下组：儿童（<18 岁）、青年（18-44 岁）、中年（45-64 岁）和老年（≥65 岁）。我们收集了所有患者的人口统计学信息、病史、实验室结果、疾病严重程度评估和死亡率统计数据。
结果
总体而言，不同年龄组 DILI 病例的分布如下：儿童 6.57%，青年 24.82%，中年 49.06%，老年 19.54%。女性比例随年龄增长而增加，从儿科组的 36.47%上升到老年组的 60.51%。值得注意的是，中枢神经系统药物（15.44%）和抗感染药物（21.80%）在儿童中更常与 DILI 相关，而心血管药物（10.58%）和草药膳食补充剂或传统药物（H/TMs）（26.29%）在老年 DILI 患者中更为常见。在所有年龄组中，儿童组更常见肝细胞型 DILI（p<0.001），而老年组更常见胆汁淤积型 DILI 和慢性 DILI（p<0.001）。急性肝衰竭（ALF）和死亡结局在儿科和老年组更为常见，特别是在儿科组（2.04%，p=0.041；0.85%，p=0.007）。
结论
儿童和老年人在 DILI 后发生不良后果的风险更高。
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