Abstract: Objective To analyze the clinical characteristics of patients with chronic drug-induced liver injury (DILI) and to explore the impact of these clinical characteristics on the outcome of the disease.Methods 340 cases of chronic DILI patients from March 2018 to March 2021 in our hospital were selected. After treatment for 6 months, the patients were divided into poor prognosis group (n=102) and good prognosis group (n=38). The basic data, clinicopathological data and related indexes of liver function were compared between the two groups. The median values of ALT, AST, Alb, TBil and DBil were taken as the cut-off values, and the risk factors were analyzed by logistic regression.Results In 340 patients, there were more than a dozen different kinds of drugs causing chronic DILI, among which traditional Chinese medicine accounted for 31.18%, antipyretic and analgesic drugs accounted for 12.35%, antitumor drugs accounted for 11.76%, antibiotics accounted for 9.41%, followed by hormones, cardiovascular medication, health care products. In the poor prognosis group, age ≥ 60 years old, and the proportions of patients with cholestasis or mixed type were 57.84% and 63.74%, which were significantly higher than 41.60% and 37.82% in the good prognosis group. The levels of ALT, AST, ALP, TBil, DBil and GGT in the poor prognosis group were (524.58 ± 89.53) U/L, (408.45 ± 89.56) U/L, (192.42 ± 78.45) U/L, (43.25 ± 12.64) μmol/L, (32.58 ± 12.41) μmol/L, (148.52 ± 51.44) U/L, which in the good prognosis group were (329.75 ± 87.55) U/L, (272.41 ± 78.48) U/L, (176.52 ± 69.86) U/L, (32.15 ± 14.15) μmol/L, (28.47 ± 8.97) μmol/L, (139.45 ± 42.52) U/L, respectively. The levels of ALT, AST, TBil and DBil in the poor prognosis group were significantly higher than those in the good prognosis group. Alb level was (45.15 ± 15.42) g/L in the poor prognosis group, which was significantly lower than that in the good prognosis group (59.86 ± 17.45) g/L (P<0.05). Logistic analysis showed that Age ≥ 60 years, non-hepatocellular type, ALT≥435.40 U/L, AST≥325.24 U/L, Alb≤52.15 g/L, TBil≥38.53 μmol/L, DBil≥29.14 μmol/L were risk factors for poor prognosis of chronic DILI.Conclusion There are many drugs causing chronic DILI, and age, types of liver injury and liver biochemical indexes have a great relationship with the outcome of patients with chronic DILI. Patients’ liver function indexes should be closely monitored and intervention in time should be carried out to control the occurrence and development of DILI while using drugs prone to cause chronic DILI.

Key words: Drug-induced liver injury, Clinical features, Outcome, Liver biochemical index