Abstract: Objective To compare and analyze the clinical and serological characteristics and differences of patients with different pathological types of chronic drug-induced liver injury (DILI). Methods 86 patients with chronic DILI by histopathology were retrospectively observed at the Fifth Hospital of Shijiazhuang. Patients were divided into chronic lobular hepatitis group and chronic cholestasis group according to different pathological injury targets. The general data, medication history, allergy history, course of disease, clinical severity grading, combined with other underlying diseases, recurrent attacks, and previous serological indicators during the course of the disease were compared between the two groups. Results Middle-aged and elderly female patients aged 45 years and above were more common in both groups, and there was no statistical difference in gender composition ratio and average age between the two groups (P>0.05). The number of recurrent episodes in chronic hepatitis group was higher than that in chronic cholestasis group (P<0.05). Overall, there was significant difference in clinical severity between the two groups (P<0.05). There was no significant difference in the mean course of disease between the two groups (P>0.05). The most common drugs used in the two groups were traditional Chinese medicine or proprietary Chinese medicine with a total of 44 cases (51.2%). There were 45 cases (52.3%) of combined drug use, 27 cases (31.4%) of single drug use, and 14 cases (16.3%) of chemical contact history. There was no significant difference in the proportion of detailed drug use between the two groups (P>0.05). Hypertension, diabetes and hyperlipidemia accounted for the top three comorbidities in both groups. A total of 16 patients (18.6%) had allergic history in the two groups. Serum ALP, GGT, TC, PA, HDL and LDL in chronic cholestasis group were higher than those in chronic hepatitis group (P<0.05). LY% in chronic hepatitis group was higher than that in chronic cholestasis group (P<0.05). The most common autoantibody in both groups was antinuclear antibody (ANA), with 36 cases (41.9%). AMA in chronic cholestasis group was significantly higher than that in chronic hepatitis group (P<0.05). There was no significant difference in other autoantibody indexes between the two groups (P>0.05). Conclusion Patients with different pathological types of chronic DILI have different clinical and serological characteristics. It is of great significance for clinicians to understand the of patients with different pathological types in understanding chronic DILI.

Key words: Chronic, Drug-induced liver injury, Hepatitis type, Cholestatic type, Clinical features, Serology