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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 36 Issue 12
Dec.  2020
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Article Contents

Etiology of abnormal liver function in elderly patients with no viral hepatitis based on pathological diagnosis: An analysis of 50 cases

DOI: 10.3969/j.issn.1001-5256.2020.12.021
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  • Received Date: 2020-07-23
  • Published Date: 2020-12-20
  • Objective To investigate the pathology,clinical features,population features,and etiology of non-viral hepatitis-related abnormal liver function in the elderly. Methods A retrospective analysis was performed for 50 elderly patients,with abnormal liver function as disease onset for the first time,who were hospitalized and treated in Beijing YouAn Hospital,Capital Medical University,from January2017 to September 2019. Abnormal liver function was defined as elevated alanine aminotransferase( ≥2 × upper limit of normal),with or without the increases in the serum levels of aspartate aminotransferase,total bilirubin,alkaline phosphatase,and gamma-glutamyl transpeptidase,and there was no limit for the duration of abnormal liver function. According to the method for obtaining pathological specimens,the patients were divided into percutaneous liver biopsy group and transjugular liver biopsy group. The etiology of abnormal liver function was analyzed,and clinical features and laboratory markers were summarized. The t-test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. Results A total of 50 patients were enrolled,with a mean age of 64. 7 ± 3. 7 years,and there were 19 male patients and 31 female patients. Of all patients,21 underwent transjugular liver biopsy and 29 underwent percutaneous liver biopsy. Pathological examination showed that 20 patients( 40. 0%) were diagnosed with drug-induced liver injury,among whom 3 had autoimmune phenomena,1 had liver failure,and 4 had hepatic veno-occlusive disease/hepatic sinusoidal obstruction syndrome; 5 patients( 10. 0%) were diagnosed with autoimmune liver disease,among whom 3 had primary biliary cholangitis and 2 had autoimmune hepatitis( 1 patient already had liver cirrhosis); 4 patients( 8. 0%) were diagnosed with nonalcoholic fatty liver disease. The etiology was not determined for 16 patients( 32. 0%),among whom 8 had liver cirrhosis,6 had hepatitis,and 2 had bile duct disease. In addition,there were 2 patients with non-cirrhotic portal hypertension( 4. 0%),1 patient with amyloidosis( 2. 0%),and 2 patients with liver failure( 4. 0%). Conclusion Drug-induced liver injury has the highest incidence rate among non-viral hepatitis-related abnormal liver function in the elderly,which is often associated with the use of drugs for chronic diseases and Chinese patent drugs. Transjugular liver biopsy may help to determine the etiology of severe liver diseases.

     

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  • [1] LIU XC,ZHAO T,ZHAO ZM,et al. Analysis of the epidemic trend of viral hepatitis in Chinese residents[J]. Zhejiang J Prevent Med,2018,30(5):433-437.(in Chinese)刘小畅,赵婷,赵志梅,等.中国居民病毒性肝炎流行趋势分析[J].浙江预防医学,2018,30(5):433-437.
    [2] GHARIPOUR M,SADEGHI M. Pivotal role of microRNA-33 in metabolic syndrome:A systematic review[J]. ARYA Atheroscler,2013,9(6):372-376.
    [3] HU Z,PENG XZ. Rethinking on Population Aging and Its Policies[J]. Stud on Soc Chin Charac,2019,5:60-67.(in Chinese)胡湛,彭希哲.对人口老龄化的再认识及政策思考[J].中国特色社会主义研究,2019,5:60-67.
    [4] National Statistics of the People’s Republic of China. 2018 national economic and social development statistical bulletin[EB/OL].[2019-02-28]. http://www. stats. gov. cn/tjsj/zxfb/201902/t20190228_1651265. html.(in Chinese)中华人民共和国国家统计.2018年国民经济和社会发展统计公报[EB/OL].[2019-02-28]. http://www. stats. gov. cn/tjsj/zxfb/201902/t20190228_1651265. html.
    [5] National Health and Family Planning Commission,National Development and Reform Commission,Ministry of Education of the People’s Republic of China,et al. Circular on issuing the13th five-year plan for healthy aging[J]. Gazette of the National Health Commission of People’s Republic of China,2017,3:15-20.(in Chinese)国家卫生计生委,国家发展改革委,教育部,等.关于印发“十三五”健康老龄化规划的通知[J].中华人民共和国国家卫生和计划生育委员会公报,2017,3:15-20.
    [6] Liver Failure and Artificial Liver Group,Chinese Society of Infectious Diseases,Chinese Medical Association; Severe Liver Disease and Artificial Liver Group,Chinese Society of Hepatology,Chinese Medical Association. Guideline for diagnosis and treatment of liver failure(2018)[J]. J Clin Hepatol,2019,35(1):38-44.(in Chinese)中华医学会感染病学分会肝衰竭与人工肝学组,中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南(2018年版)[J].临床肝胆病杂志,2019,35(1):38-44.
    [7] National Health and Family Planning Commission Statistical Information Center. 2013 fifth National health service survey analysis report[R/OL].[2016-10-26]. http://www. nhc. gov. cn/mohwsbwstjxxzx/s8211/201610/9f109ff40e9346fca76dd82cecf419ce. shtml.(in Chinese)国家卫生计生委统计信息中心.2013第五次国家卫生服务调查分析报告[R/OL].[2016-10-26]. http://www. nhc. gov.cn/mohwsbwstjxxzx/s8211/201610/9f109ff40e9346fca76dd82cecf419ce. shtml.
    [8] FURUTACHI S,MIYA H,WATANABE T,et al. Slowly dividing neural progenitors are an embryonic origin of adult neural stem cells[J]. Nat Neurosci,2015,18(5):657-665.
    [9] WANG J,MA YY,LIU CH,et al. An epidemiological analysis of drug-induced liver injury based on literature[J]. Chin J Integr Tradit West Med Liver Dis,2019,29(5):452-455,458.(in Chinese)王静,马园园,刘成海,等.基于文献的药物性肝损伤流行病学分析[J].中西医结合肝病杂志,2019,29(5):452-455,458.
    [10] REN ZQ,WANG JH,GUO XY,et al. Comprehensive clinical analysis of drug-induced liver injury in my country from 2005to 2014[J]. Chin J Pharmacoepidemiol,2016,25(5):284-289.(in Chinese)任张青,王进海,郭晓燕,等.2005-2014年我国药物性肝损伤临床综合分析[J].药物流行病学杂志,2016,25(5):284-289.
    [11] WANG YZ,ZHANG Y. Research advances in drug-induced liver injury in the elderly[J]. J Clin Hepatol,2016,32(4):821-824.(in Chinese)王悦之,张玉.老年药物性肝损伤的研究进展[J].临床肝胆病杂志,2016,32(4):821-824.
    [12] JIA ZA. Analyze and explore the clinical characteristics of druginduced liver disease in the elderly[J]. J World Latest Med Inf,2019,19(70):61,64.(in Chinese)贾赞安.分析探讨老年药物性肝病的临床特点[J].世界最新医学信息文摘,2019,19(70):61,64.
    [13] PAN C,SHEN S. Analysis of the clinical characteristics of 15336 cases of drug-induced liver injury[J]. Clin Med J,2018,16(9):43-47.(in Chinese)潘晨,沈素.15336例药物性肝损伤的临床特点分析[J].临床药物治疗杂志,2018,16(9):43-47.
    [14] LUO Q,ZHU GR,GU HT,et al. Comparison of liver histopathological characteristics in 50 patients with drug-induced liver injury caused by Chinese herbal medicine and Western medicine[J]. J Clin Hepatol,2020,36(3):596-601.(in Chinese)罗琼,朱哿瑞,顾宏图,等.50例中草药与西药致药物性肝损伤患者的肝组织病理学特点比较[J].临床肝胆病杂志,2020,36(3):596-601.
    [15] ELINAV E,PINSKER G,SAFADI R,et al. Association between consumption of Herbalife nutritional supplements and acute hepatotoxicity[J]. J Hepatol,2007,47(4):514-520.
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