中国人群药物性肝损伤预后不良的影响因素系统评价

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中图分类号R975+.5 文献标志码A 文章编号 1001-0408（2026）05-0665-05

DOI 10.6039/j.issn.1001-0408.2026.05.20

Influencing factors for poor prognosis of drug-induced liver injury in Chinesepopulation：a systematic review

WANG Weimei， WANG Lidan，MENG Jia，PING Ze，ZHANG Xiaoyan[Dept. of Pharmacy，Hengshui People's Hospital （Harrison International Peace Hospital），Hebei Hengshui，O53ooO，China]

ABSTRACTOBJECTIVETosystematicallyevaluate theinfluencingfactorsafectingthepooprognosisofdrug-induced liver injury（DILI）intheChinesepopulation，andtoprovideevidence-basedsupportforearlyidentificationandinterventionsofDIL. METHODSRetrievedfromPubMed，Medline，Embase，theCochraneLibrary，CNKI，Wanfangdatabase，Chinabiomedical medicine database（CBM）andVIP，clinical studies（case-controlstudies，cohort studies）relatedtoinfluencing factorsforpoor prognosisofDIIwerecolectedfrominceptiontoMay31，2025.Afteriteraturescreeing，dataextractionandqualityevaluation of includedstudies，meta-analysiswascariedoutbyusingRevMan5.4software.RESULTSAtotalof17literature were included，involving4O78DILIpatients，ofwhom673wereinthepoorprognosisgroupand345wereinthefavorableprognosis group.Meta-analysis showed that history of liver disease （ OR=2.47 ， 95%CI was 1.61-3.78， P<0.001 ），alcohol drinking history （ OR=1.77 ， 95%CI was 1.22-2.56， P=0.003 ），Chinese herbal medicine/Chinese patent medicine（ OR=1.87 ， 95%CI was 1.30- 2.70， P<0.001 ），non-hepatocellular injury type（ OR=1.70 95%CI was 1.37-2.10， P<0.001 ），international normalized ratio （INR）elevated （ OR=2.51 ， 95%CI was 1.97-3.19， P<0.001 ），and alanine transamine （ALT） elevated （ OR=1.27 ， 95%CI was 1.14-1.41， P<0.001 ）were risk factors of poor prognosis in DILI.Higher albumin（ALB）level （ OR=0.47 ， 95%CI was 0.39- 0.57， P<0.001 ），elevated prothrombin activity（PTA）（ OR=0.88 ， 95%CI was 0.85-0.91， P<0.001 ）andmore than 2kindsof hepatoprotective drugs（ OR=0.62 ， 95%CI was 0.41-0.95， P=0.030 ）were protective factors for poor prognosis of DILI. CONCLUSIONSPatientswithalcoholdrinkinghistory，historyofliverdisease，elevatedINR，elevatedALT，taking Chinese herbalmedicine/Chinesepatent medicine，andnon-hepatocelularinjurytypeofDILIhaveagreaterriskofporprognosis，andhigher ALB level，higher PTA and more than 2 kindsof hepatoprotective drugs can reduce the risk of poor prognosis of DILI.

KEYWORDSdrug-induced liver injury； poorprognosis; influencing factors；systematic review

药物性肝损伤（drug-induced liver injury，DILI）是一种由药物本身或其代谢产物引起的肝脏损伤，是临床常见药物（特别是中草药制剂、抗结核药物、抗感染药物和抗肿瘤药物等）导致的不良反应之一。（剩余10089字）