高危人群抗结核药物性肝损害分析

目的：探讨高危人群抗结核药物性肝损害的特点。方法：选取我院结核科抗结核治疗94例存在高危因素人群病人,统计两组在抗结核治疗中出现药物性肝损害的时间及临床症状,肝损发生率及引起肝损的原因。结果：对照组（未干预）肝损发生率、程度和合并黄疸的例数、均较实验组（干预）升高,出现肝损与时间之间两组存在显著性差异,而ALT120～200U/L的例数较对照组降低。两组资料显示引起药物性肝损的原因中以利福平为主,出现药物性肝损的时间高峰为4周以内,而引起肝损的3种药物的构成比差异无显著性（P〉0.05）。结论：对于老年人、长期饮酒者、HBV感染者、营养不良、免疫功能低下者这些高危因素人群抗结核治疗时给予干预方案,可以减少肝损发生。

Analysis of liver injuries caused by anti-tuberculosis drugs in high risk individuals

Objective：To study the characteristics of liver injury caused by anti-tuberculosis （TB） drugs in the high risk individuals.Methods：94 tuberculosis patients with high risk factors occurred in the course of anti-TB treatment were sampled from our hospital in 2007~2008,and divided into the experimental group（no intervention） and control group （intervention）.The frequency,degree,causes,appearance of liver injuries caused by anti-tuberculosis drugs and the difference of clinical symptoms between the two groups were compared.Results：The incidence,extent of liver damage and the cases of complicating jaundice in the experimental group were increased compared with the control group.The occurrence time of liver damage had significant difference between the two groups,while the number of patients with ALT 120 ~ 200 U/L in the control group was lower than that in the experimental group.The data of the two groups showed that the cause of drug-induced liver damage was mainly rifampicin,the time peak of the druginduced liver damage occurrence was within 4 weeks,while the constituent ratio of the three drugs inducing liver damage had no significant difference （P0.05）.Conclusion：The high risk individuals such as the elderly,long-term drinkers,HBV infection,malnutrition and weak immunologic function should be given intervention programs in the treatment of anti-TB,which could reduce the occurrence of drug-induced liver damage.