99例HBsAg阳性肺结核患者化疗致肝功能损害研究

目的探讨HBsAg阳性肺结核患者应用抗结核药物治疗对肝功能的影响。方法收集该院住院肺结核患者179例,根据HBsAg检测情况分为观察组和对照组,对比两组患者抗结核治疗肝功能损害情况。结果观察组药物性肝损害发生率58.24%高于对照组17.05%,且两组在轻、中、重度肝损害方面差异均有统计学意义(P0.05)。观察组AST112.8±84.3IU/L和ALT153.4±87.5IU/L明显高于对照组的86.7±70.5IU/L和103.3±71.3IU/L(P0.05)。观察组肝损害时间早于对照组。结论乙肝表面抗原阳性者在抗结核治疗过程中较阴性者更易发生肝功能损害,应当选用肝损害小的药物。

Clinical observation on liver function impairment caused by anti-tuberculosis treatment in 99 patients with positive HBsAg

Objective To study liver function impairment caused by anti-tuberculosis treatment in patients with positive HBsAg. Methods The study selected 91 tuberculosis patients with positive HBsAg and 88 tuberculosis patients with negative HBsAg. The liver function impairment and related factors between the two groups were com-pared. Results The rate of liver function damage was 58. 24% in the HBsAg positive group and 17. 05% in the HB-sAg negative group. There were statistical significant differences in mild, moderate and severe liver damage between the two groups （P〈0. 05）. The AST （112. 8 ± 84. 3IU/L） of the observation group was higher than that in the con-trol group （86. 7 ± 70. 5IU/L）. The ALT （153. 4 ± 87. 5IU/L） of the observation group was higher than that in the control group （103. 3 ± 71. 3IU/L） （P〈0. 05）. The onset time was in two weeks and from two weeks to four weeks in the two groups respectively. There was a statistical significance in onset time in two weeks （P〈0. 05）. Conclu-sion Anti-tuberculosis drugs induced liver damage is more in tuberculosis patients with HBsAg positive than who with negative HBsAg. Comprehensive prevention measures must be taken and it should provide drugs which can cause less liver damage.