Abstract: Objective To investigate the clinical characteristics and medication history of patients with drug-induced liver injury. Methods A total of 166 patients diagnosed with drug-induced liver injury and admitted to the first affiliated hospital of Chongqing Medical University between January 2018 and June 2022 were included in this study. Patients were divided into three groups based on their medication history: Chinese herbal medicine, Chinese patent medicine, or health products-induced liver injury group (HDS group, n=61), Western medicine-induced liver injury group (DILI group, n=65), and mixed medication group (MIX group, n=40). Statistical analysis was conducted using SPSS and EXCEL. Results The majority of patients were female, under the age of 60, with a BMI below 24 kg/m², no history of alcohol consumption, and no prior drug-induced liver injury. They predominantly exhibited hepatocellular liver injury. Patients in the DILI group had the highest incidence of prior drug-induced liver injury (8 cases, χ⁼6.334, P=0.033). The HDS group showed the highest liver injury grade (1/3/4/5) on admission (14/45/2/0, χ²=28.683, P<0.001), and significantly elevated total bilirubin level [115.6 (129.7), H=30.515, P<0.001]. There were no significant differences in the utilization of artificial liver, the use of hormone therapy, length of hospital stay, and clinical outcomes among the three groups. There was one case (1.2%) of drug-induced autoimmune hepatitis or cholangitis. The most common drugs causing liver injury included Chinese herbal medicine (26.5 %) used for 30 days, Western medicine combined with other drugs (10.2 %) for 22 days, anti-tuberculosis drugs (9.6 %) for 30 days, Chinese patent medicine (7.2 %) for 30 days, antipyretic-analgesic and anti-inflammatory drugs (6.0 %) for 10.5 days, anti-malignant tumor drugs (6.0 %) for 1.5 days, multi-type western drugs (6.0 %) for 17.5 days, other anti-infective drugs (5.4 %) 3 for days, and unknown drug use (13.9 %) for 25 days. Conclusion Patients with drug-induced liver injury are typically female, young, have normal or low weight, and tent to have hepatocellular type injury. Liver function tests should be conducted after a one-day course of antitumor drugs, a 10-day regimen of antipyretic analgesics and anti-inflammatory drugs, and a 3-day treatment with non-antituberculosis antibacterial agents to detect potential liver injury early. The concurrent use of multiple drugs emerges as a significant contributor to liver injury. Although patients with liver injury from Chinese herbal medicine, Chinese patent medicine, or health products exhibit higher total bilirubin levels and liver injury grades upon admission compared to those in the western medicine group, outcome were similar between the two groups.

Key words: Drug-induced liver injury, Duration of medication, Mixture of medicines, The surveillance of hepatic function