The Journal of Practical Medicine ›› 2023, Vol. 39 ›› Issue (6): 747-751.doi: 10.3969/j.issn.1006⁃5725.2023.06.016

• Drugs and Clinic Practice • Previous Articles     Next Articles

Efficacy and dose selection of glucocorticoid for severe drug ⁃induced liver injury

ZHANG Dandan*，XU Feng，LI Ya，SONG Ruifeng，LIU Lin.    

  1. Department of Gastroenterology，the First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China 

  • Online:2023-03-25 Published:2023-03-25

Abstract:

Objective To investigate the efficacy and dose selection of glucocorticoid in severe drug⁃ induced liver injury. Methods Data of 232 patients with severe drug ⁃induced liver injury who admitted to The First Affiliated Hospital of Zhengzhou University hospital from September 2018 to August 2021 were collected. According to the use of glucocorticoid and their dose during the course of disease，they were divided into hormone group（further divided into < 0.5 mg/（kg·d）group and ≥ 0.5 mg/（kg·d）group）and control group. The efficacy of ALT，AST，DBIL，IBIL，TBIL and complication were analyzed，between hormone group and control group，different dose of hormone group. Results （1）The mean hospital stay between the hormone group and the control group was statistically different（P < 0.05），the number of days of hospitalization in the hormone group was 18.00（13.00， 24.00）days，and that in the control group was 21.00（15.00，29.00）days. There was statistical difference between two group in the time required for the reduction of AST，DBIL，IBIL and TBIL by 30% and 50% compared with the baseline value（P < 0.05）. There was no statistical difference between two group in the time required for the reduction of ALT by 30% and 50% compared with the baseline value（P > 0.05）.（2）The days of ALT，AST， DBIL，IBIL and TBIL decrased by 30%，50% compared with the baseline value in the different doses of hormone group was no statistically difference（P > 0.05）.（3）There were statistically difference in infection⁃related adverse reactions between the hormone group and the control group，and between different doses of hormone group（P < 0.05）. Conclusion Glucocorticoid combined with conventional liver ⁃ protecting drugs can improve the levels of AST， DBIL，IBIL and TBIL in the patients with severe drug⁃induced liver injury. There was no statistical difference in the improved of ALT，AST and TBIL with different doses of glucocorticoid，but when the dose of hormone group was ≥ 0.5 mg/（kg·d），the incidence of infection was higher. 

Key words:

severe drug?induced liver injury, glucocorticoid, efficacy, dose