Drug-related liver injury is becoming a & quot;hidden killer" of health
"Among all hospitalized liver disease patients, more than 1 out of every approximately 10 liver disease patients suffer from drug-related liver injury." On July 28, Zou Zhengsheng, chief physician of the Department of Liver Medicine at the Fifth Medical Center of the PLA General Hospital, said that the incidence of non-infectious liver diseases in China is on the rise year by year, with drug-related liver injury being a major non-infectious liver disease that is increasingly becoming an "invisible killer" threatening human health.
Studies show that more than 1100 drugs and herbs can cause drug-related liver injury. Zou Zhengsheng pointed out that in Europe and the United States, the drugs that cause drug-related liver injury are mainly antibiotics and anti-inflammatory and analgesic drugs. In China, Chinese medicine or Chinese herbal medicine is more common drugs that cause drug-related liver injury.
"Herbal drugs that cause liver injury are more difficult to diagnose. The active ingredients of herbal medicines are complex and their combinations are more complicated; the combination of Chinese and Western medicines may have interactions that increase the risk of liver injury and are more difficult to distinguish and judge." Said researcher Xiao Xiaohe, director of the academic committee of the Department of Liver Medicine at the Fifth Medical Center of the PLA General Hospital and director of the All-Army Institute of Chinese Medicine.
In order to solve the problem of liver injury caused by herbal medicine is difficult to diagnose, Xiao Xiaohe led the team to create the "integrated evidence chain method" and three levels of diagnostic criteria for the evaluation of causality of liver injury of medicinal origin, which can significantly reduce the misdiagnosis rate of liver injury caused by herbal medicine. Currently, the diagnostic method and criteria have been incorporated into the guidelines of the Chinese Academy of Traditional Chinese Medicine, the guidelines of the State Drug Administration and the guidelines of the International Council of Medical Sciences.
"The vast majority of drug-related liver injuries do not have a specific treatment." Zou Zhengsheng said its main treatment principles include discontinuing and avoiding the reuse of suspected or similar drugs after fully weighing the risk of subsequent aggravation of the original disease; specific detoxification therapy; appropriate use of liver-protective, enzyme-lowering and anti-yellowing drugs; and emergency liver transplantation can be considered when necessary in patients with acute or subacute liver failure and other severe conditions.
Data from the Fifth Medical Center of the PLA General Hospital over the past 20 years show that nearly a quarter of patients hospitalized with drug-related liver injury relapsed and became chronic after six months of cure or improvement. In response to this situation, the research team of the Fifth Medical Center of PLA General Hospital has established a recurrent chronic drug-related liver injury prediction model, which can effectively predict the population prone to chronic liver injury, and based on this, explored a 48-week glucocorticoid regimen for chronic recurrent drug-related liver injury. These results provide a feasible solution for the revision of future guidelines for the diagnosis and treatment of drug-induced liver injury. (Bai Zhaofang, Han Lin, reporter Zhang Qiang)
Source: Science and Technology Daily