抗结核治疗对携带HBV的肺结核病患者肝功能的影响

目的　探讨抗TB治疗过程中HBV携带与肝功能损害的关系 ,比较HPBE(S)和HLAMKO两种化疗方案对肝功的影响。方法　选择HBV携带的TB患者 47例 ,非HBV携带的TB患者 170例 ,随机分成HPBE(S)和HLAMKO两个治疗组 ,于治疗前和治疗后每 2wk检测肝功能 ,并观察临床症状。结果　 47例HBV携带的TB患者发生肝功损害 2 6例 ( 5 9% ) ,明显高于非HBV携带者40例 ( 2 4% ) ;在所有 2 17例患者中 ,不同程度肝功能损害者共 66例 ( 3 0 4% ) ,其中应用HPBE(S)方案组 115例发生肝损害 5 3例( 4 6 1% ) ,HLAMKO方案组 10 5例发生肝功异常者 13例 ( 12 7% )。结论　HBV携带的TB患者应选肝损害小的HLAMKO抗结核治疗方案 ,同时应用保肝药物

Effect of anti-tuberculosis therapy on the liver function of the pulmonary tuberculosis patients infected with hepatitis B virus

Objective To observe the effect of the anti_tuberculosis therapy on liver function of pulmonary tuberculosis patients with hepatitis B virus (HBV) carries, and compare the differences of liver function by two treatment fomnla of anti_tuberculosis.Methods Fourty_seven TB patients with HBV and 170 TB patients without HBV were divided into HPBE (S) and HLAMKO groups,monitored liver function before and after the treatments once 2 weeks or monthly,and recorded their clinical manifestiations.Results The rate of hepatotoxicity in 26(59%) TB patients with HBV infection during anti_TB treatments is higher than that in the 40 (24%)patients without HBV.There were 66 patients with hepatotoxicity in the 217 patients observed,and the incidence of liver dysfunction was significantly higher in regiment HPBE (S)compared with GLAMKO (P<0.01),respectively (46.1% and 12.7%).Conclusion TB patients with HBV infection should choose HLAMKO which has low hepatotuxicity.