结核病患者抗结核治疗中预防性保肝的临床疗效

目的分析预防性保肝治疗在无高危因素结核病患者治疗中的临床意义。方法选取2016年1月-2017年10月昆明市第三人民医院收治的结核病患者380例,根据治疗方法不同分为观察组200例和对照组180例。观察组抗结核治疗同时给予预防性保肝治疗,对照组仅予抗结核治疗,比较2组肝功能损伤情况。结果观察组肝损伤发生率低于对照组(P<0.05),但各组均未出现急性肝衰竭及致命情况。2组所致肝损伤均以肝细胞损伤型为主。观察组治疗后AST、ALT、TBIL、IDBIL水平均低于对照组,差异均有统计学意义(P<0.05)。结论在抗结核治疗中给予预防性保肝治疗可有效降低药物性肝损伤的发生率。     

多烯磷脂酰胆碱预防抗结核药物肝损伤的临床观察

目的 探讨多烯磷脂酰胆碱预防抗结核药物致药物性肝损的临床疗效.方法 将诊断明确的结核病人68例(既往无肝病)随机分成对照组32例和治疗组36制,治疗组用抗结核药物+多烯磷脂酰胆碱注射液(易善复)465mg;对照组单用抗结核药物.结果 治疗组肝损伤的发生率(11.1％)明显低于对照组(25.0％),肝损伤程度显著低于对照组(P＜0.05).结论 多烯磷脂酰胆碱能有效预防抗结核药物肝损伤.     

保肝药预防急性髓性白血病初次化疗致肝损伤的效果分析

目的:探讨保肝药在急性髓性白血病(acute myeloid leukemia,AML)化疗致肝损伤中的预防效果。方法:收集北京大学人民医院血液科2012年1月至2017年12月期间初治使用阿糖胞苷联合伊达比星(AI)方案化疗的初诊患者。记录患者基本信息和化疗前后肝功能生化指标,根据使用保肝药的数量,分为4组(对照组,1组,2组,3组),比较各组肝损伤发生率。根据使用保肝药的品种,将每组分为若干个亚组,比较各亚组肝损伤发生率。结果:对照组、1组、2组、3组比较,肝损伤发生率差异无统计学意义(P>0.05)。性别,年龄以及用药种类与肝损伤的的发生无明显的相关性。结论:预防性使用保肝药物并未减少接受AI方案化疗的初治AML患者肝损伤的发生。     

保肝药物对抗结核药物肝损伤的预防作用探讨

目的观察保肝药物对抗结核药物肝损伤的预防作用。方法 382例患者随机分为治疗组190例和对照组192例,治疗组给予保肝药物加抗结核药物治疗。对照组给予单纯抗结核药物治疗。观察2组肝功能损伤情况。结果治疗组肝功能损伤发生率为8.4%,对照组为9.9%,差异无统计学意义（P〉0.05）。结论对无高危因素的肺结核患者不主张常规加用保肝药物治疗。     

异甘草酸镁注射液防治化疗药物所致急性肝损伤的临床观察

目的:观察异甘草酸镁注射液对化疗药物所致急性肝损伤的防治作用。方法:第1周期化疗后出现Ⅱ°药物性肝损伤且经保肝治疗后恢复正常的恶性肿瘤患者94例,在进行第2周期化疗的同时,应用异甘草酸镁注射液150mg(治疗组,47例)或还原型谷胱甘肽注射液1.2g(对照组,47例)进行预防性保肝治疗,均为1次/d,疗程2周。肝损伤<Ⅱ°者为有效。结果:治疗后治疗组与对照组的有效率分别为80.9%、55.3%(P<0.01),丙氨酸氨基转移酶分别为(20.8±9.4)、(35.4±7.1)U·L-(1P<0.05)。结论:异甘草酸镁注射液对于化疗药物所致急性肝损伤有良好的防治作用。     

62例肺结核患者抗结核药物治疗致药物性肝损伤的危险因素分析及其防治对策

目的:分析肺结核患者抗结核药物治疗致药物性肝损伤(DILI)的危险因素,为防治DILI发生提供参考.方法:选取医院2017年7月-2018年9月收治的肺结核患者62例病历资料,根据治疗期间是否发生肝损伤分为观察组(n=27,有肝损伤)和对照组(n=35,无肝损伤),统计其患者性别、年龄以及饮酒史、吸烟史、肝病史等基础资料,采用单因素及多因素Logistic回归分析其发生药物性肝损伤的相关因素及其防治对策.结果:分析后发现,抗结核药物治疗致DILI与患者年龄≥40岁、BML28、酗酒、吸烟、脂肪肝、糖尿病、高血压、未用保肝药、营养不良等影响因素(P＜0.05)具有相关性;经多因素Logistic回归分析结果显示患者年龄(≥40岁)、酗酒、脂肪肝、糖尿病、高血压、营养不良、未应用保肝药为导致肺结核患者发生DILI的独立危险因素(P＜0.05).结论:年龄(≥40岁)、酗酒、脂肪肝、糖尿病、高血压、营养不良、未应用保肝药等均为导致肺结核患者抗结核治疗DILI的独立危险因素,临床在抗结核药物治疗过程中应高度重视并采取针对性措施,以积极防治DILI发生,确保抗结核分枝杆菌治疗的有效性.     

36例药物性肝损伤的临床特点分析

目的了解药物性肝病的临床特征及诊断,提高临床医师对该病的认识,并给予及时有效的治疗。方法采用回顾性调查方法对我院收治的36例急性药物性肝病患者的临床表现、病因及其治疗转归进行分析,总结药物性肝损伤的常见药物,及保肝药物的应用。结果36例药物性肝病患者在服药过程中起病;药物性肝损伤临床表现特异性不强,各种保肝药物治疗效果比较差异无统计学意义(P>0.05)。结论药物性肝损伤患者以中药、抗结核药及免疫抑制剂常见,停用相关药物后,预后良好,加强监测是预防药物性肝损伤发生的关键。     

抗结核药致中国人群药物性肝损伤危险因素的Meta分析

摘要：目的 系统评价中国人群使用抗结核药致药物性肝损伤的危险因素。方法 检索PubMed、Embase、Cochrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数据库以及维普数据库(VIP)中建库至2019年10 月发表的有关中国人群使用抗结核药致药物性肝损伤的研究文献,2名研究员独立按照纳入与排除标准筛选文献、提取资料及 质量评价后,采用RevMan 5.3软件进行Meta分析。结果 共纳入12篇文献,均为中文文献,纳入8216例患者,共筛选出13种 暴露因素。Meta分析结果显示,嗜酒(OR=2.54,95%CI：1.97~3.27)、肝病史(OR=2.60,95%CI：2.19~3.08)、乙肝表面抗原携 带者(OR=3.15,95%CI：2.66~3.73)、糖尿病(OR=1.41,95%CI：1.18~1.70)、心功能不全(OR=1.72,95%CI：1.28~2.30)、贫血 (OR=4.61,95%CI：2.43~7.90)、营养不良(OR=2.48,95%CI：1.63~3.77)和结核病复治(OR=1.93,95%CI：1.43~2.60)是抗结核 药物致肝损伤的危险因素(P<0.05)。预防性予以保肝药能显著减少抗结核药致肝损伤的发生率(OR=0.36,95%CI：0.25~0.50, P<0.001)。结论 贫血、乙肝表面抗原携带者、合并其他肝病史、嗜酒、营养不良、结核病复治、心功能不全、糖尿病是我国 人群使用抗结核药致肝损伤的危险因素。对于有高危因素的患者予以保肝药能显著降低抗结核药致肝损伤的发生率。     

抗肿瘤药物致急性药物性肝损伤的临床分析

目的总结抗肿瘤药物致急性药物性肝损的临床特点,归纳引起急性药物性肝损的化疗方案和化疗药物。方法统计2011年药物性肝损伤病例数,从药物与肝损伤的关联程度、分型特征、临床表现、药物类别和治疗与转归各方面评价抗肿瘤药物所致急性肝损伤的特征。结果在116例可供评价的病例中,112例与抗肿瘤药物存在相关。临床表现以乏力(38.4%)、纳差(36.6%)为主,临床分型主要为肝细胞损伤型(60例,53.6%)和胆汁淤积型(38例,33.9%),常见致急性药物性肝损伤方案有TP方案、FOLFOX方案、GP方案。抗肿瘤药类别排前三位的是铂类、抗代谢类、影响微管蛋白药物。结论急性药物性肝损伤以肝细胞损伤型为主,主要表现为乏力,以铂类抗肿瘤药物及相关化疗方案最常见,患者预后较好。     

当飞利肝宁胶囊防治抗结核药物性肝损伤临床分析

目的：探讨当飞利肝宁胶囊防治抗结核药物性肝损伤的保肝作用。方法：将121例初治结核病患者随机分为两组,实验组61例,对照组60例。实验组加用当飞利肝宁胶囊,对照组未加用任何保肝药。每月复查肝功能,若出现轻度肝功损伤则加用当飞利肝宁胶囊保肝治疗。结果：肝损伤发生率对照组显著高于实验组（P<0.05）,差异有统计学意义;轻度肝损害者肝功能治愈率达80%,有效率100%。结论：当飞利肝宁胶囊能有效预防和治疗抗结核药物所致肝损伤。     

Discontinued drugs in 2005: schizophrenia drugs

This paper is the third in a series discussing drugs dropped from development in 2005. Schizophrenia is particularly interesting with regard to pipeline discontinuation, and appears to be unique in this data set because the number of discontinuations far exceeds that for other neuropsychiatric conditions. If this is taken as a proxy for overall drug discovery activity, it represents a very large amount of activity across a wide range of big pharmaceutical corporations. It is also clear that many of the discontinued drugs have mechanisms of action that would make them theoretically suitable as treatments for schizophrenia. Why should so much activity be directed towards what many may consider an undeserving, relatively untreatable and relatively non-rehabilitatable group of patients? This is debated in this opinion piece.     

Discontinued drugs in 2008: oncology drugs

The failure of drug candidates in clinical development remains a critical issue for the pharmaceutical and biotechnology industries. This article documents those oncology drugs discontinued in 2008 and briefly reviews reasons for termination of development. Source information was derived from a search of the Pharmaprojects database for drugs reaching phase I – III clinical trials.     

Discontinued drugs in 2011: oncology drugs

This year's analysis of discontinued drugs in oncology reveals that the trend of increasing numbers of candidate drug development terminations seen in recent years has continued into 2011. Thirty-seven drugs were dropped from the global oncology development pipeline in 2011, significantly more than the 28 discontinuations reported in 2010. Of note were the number of terminations reported for strategic reasons and the striking number of drugs (23) discontinued in or at the end of Phase I development. This article provides a summary of those drugs discontinued in 2011 and discusses the observations in the context of the rapid changes occurring in the way new anticancer drugs are developed.     

Discontinued drugs in 2011: cardiovascular drugs

This perspective is part of an annual series of papers discussing drugs dropped from development in the previous year. Specifically, this paper focuses on the 19 cardiovascular drugs discontinued in 2011 after reaching preclinical or Phase I - III clinical trials. Information for this perspective is mainly derived from a search of Pharmaprojects.     

Discontinued drugs in 2007: oncology drugs

This perspective is part of an annual series of papers discussing drugs dropped from clinical development in the previous year. Specifically, this paper focuses on the 28 oncology drugs discontinued in 2007. Information for this perspective was derived from a search of the Pharmaprojects database for drugs discontinued after reaching Phase I – III clinical trials.     

Discontinued drugs in 2010: oncology drugs

The Pharmaceutical Industry is currently undergoing a period of rapid change as the pressures of the financial markets highlight fundamental inefficiencies in the current business model. The Achilles heel for the industry is the unacceptable level of attrition in clinical drug development. An imperative for the industry is to reduce the cost and increase the efficiency of Research and Development (R&D). This article provides an analysis of cancer drugs dropped from the industry pipeline in 2010 and offers a perspective on how the future oncology drug pipeline might evolve.     

Discontinued drugs in 2007: cardiovascular drugs

This perspective is part of an annual series of papers discussing drugs dropped from clinical development in the previous year. Specifically, this paper focuses on the 16 cardiovascular drugs discontinued in 2007. Information for this perspective was derived from a search of the Pharmaprojects database for drugs discontinued after reaching Phase I – III clinical trials.     

Discontinued drugs in 2010: cardiovascular drugs

This perspective is a paper discussing drugs dropped from clinical development in the previous years. Specifically, this paper focuses on 16 cardiovascular drugs discontinued in 2010 after reaching Phase I - III clinical trials. Information for this perspective is mainly derived from a search of Pharmaprojects.