蛋白质营养不良对抗结核药物肝损害的影响

目的 探讨合并蛋白质营养不良的肺结核病患者使用抗结核药物后对肝功能的影响.方法 选取2012年9月至2015年3月我院收治的250例肺结核合并蛋白质营养不良的患者作为观察组和同期住院治疗的250例肺结核非合并蛋白质营养不良的患者作为对照组,整理患者相关临床资料.两组患者均采用常规抗结核药物治疗,观察并比较两组患者治疗第1个月和第2个月后患者肝损害的情况以及采用单因素分析观察组患者中年龄、性别、肝炎病毒和病灶范围与抗结核药物治疗后肝损伤的相关关系.结果 观察组患者治疗第1个月后肝损害的发生率明显高于对照组,差异有统计学意义(x2 =4.691,P＜0.05),而治疗第2个月后肝损害的发生情况差异无统计学意义(x2=1.109,P＞0.05);两组患者治疗第2个月后肝损害的发生率均明显低于治疗第1个月后,差异有统计学意义(x2=23.859、5.554,P值均＜0.05);观察组患者中性别、乙肝表面抗原(HBsAg)、结核病灶的范围以及患者的年龄与患者抗结核药物治疗后是否发生药物肝损害不存在特定的相关关系(x2=2.084、0.703、1.473、0.119,P值均＞0.05).结论 肺结核病患者合并蛋白质营养不良能明显升高抗结核药物治疗后肝损害的发生率,因此需对患者的肝功能进行密切监测,及早进行临床干预,并注意改善患者的营养状况,减少肝损害的发生.

Influences of protein malnutrition and drug-induced hepatitis due to antituberculosis drugs

Objective To explore the influences of protein malnutrition and drug-induced hepatitis due to antituberculosis drugs.Methods 250 pulmonary tuberculosis patients with protein malnutrition from September 2012 to March 2015 were selected as the observation group and 250 pulmonary tuberculosis patients with not protein malnutrition were selected as the control group.All the patients were treated with conventional anti-TB drugs.The liver damage after treating the firth and second month of the two groups patients were compared,and the relationship between age,gender,HBsAg and the scope of lesions and liver damage of the observation group were compared by single factor analysis.Results The incidence of liver damage after treating the firth month of the observation group was higher than the control group,the difference was statistically significant (x2 =4.691,P ＜ 0.05),but no statistical significance was showed after treating the second month (x2 =1.109,P ＞0.05);The incidence of liver damage of the two groups patients after treating the second month were lower than the firth month later,the difference was statistically significant (x2=23.859,5.554,P ＜0.05).Conclusions The incidence of liver damage after treating with antituberculosis drugs will be higher in the pulmonary tuberculosis patients with protein malnutrition,so that the liver function should be monitoring closely and intervening soomly,and nutriture of the patients should be improved to reduce liver damage.