368例肺结核患者抗结核药物所致肝功能损害的临床分析

目的探讨临床应用的一线抗结核药物引起肝损害状况。方法对比分析乙肝病毒感染单纯HBsAg(+)、HBsAg(+)和HBeAg(+)、HBsAg(+)和HBeAb(+)以及丙肝病毒携带者和肝炎病毒阴性患者之间经过抗结核治疗后肝功能损害情况。结果368例病例中,肝功能损害总的发生率为16.4%(59/358),乙肝HBeAg(+)、乙肝HBeAb(+)及丙肝病毒感染组发生肝功能损害的比率明显高于乙肝病毒阴性组和单纯HBsAg(+)组,乙肝病毒阴性组和单纯HBsAg(+)组发生肝功能损害的情况统计学上无差异。同时还发现,大于60岁年龄组发生肝功能损害的几率要明显高于小于60岁的年龄组。结论合并肝炎病毒感染、老年、是抗结核药物引起肝功能损害的主要危险因素,临床应用抗结核药物时,针对此类病人需密切关注其肝功能损害情况。

Clinical analysis on 368 pulmonary tuberculosis cases with hepatic lesion caused by anti-tuberculosis drugs

Objective To explore the status of hepatic lesion caused by first-line anti-tuberculosis(TB) drugs. Method 368 cases with hepatic lesion caused by anti-TB drugs were observed to explore the relationship between the infection status of hepatitis virus(Band C) and the hepatic lesion. Result Of 368 cases,the general rate of hepatic lesion was 16.4%(59/358).The rate of hepatic lesion among patients with HBsAg( ) HBeAg( ) and HCV was significant higher than that of patients with HBV negative.There was no significant difference between HBV negative and only HBsAg( ) group in the rate of hepatic lesion.Meanwhile,the rate of hepatic lesion among patients over 60 years was higher than that of patients less than 60 years. Conclusion Hepatic lesion is liable to occur among patients with hepatitis virus infection and the elderly patients.The hepatic function of these patients should be paid close attention to monitor after they take the first-line anti-TB drugs.