合并慢性乙型肝炎对抗痨治疗肺结核患者疗效的影响

目的观察分析不同乙型肝炎病毒载量的肺结核患者在抗结核治疗过程中肝功能的变化，了解乙型肝炎病毒对抗结核治疗的影响。方法79例HBV M阳性的肺结核患者，根据HBV DNA大于或小于1×10^5 copies／ml分为A、B组，与23例HBV M阴性肺结核患者比较在接受抗结核治疗时药物性肝炎和重型肝炎发生的情况。结果A组和B组肝功能异常出现和复常时间，及肝损害程度差异无统计学意义（P〉0．05），但均较HBV M阴性组肝功能异常出现时间早而复常时间较长，且肝损害程度明显重于阴性组（P〈0．05）；A组和B组药物性肝炎和重型肝炎发生率差异无统计学意义（P〉0．05），但均明显高于阴性组（P〈0．05）。结论对于HBV M阳性的肺结核患者，在化疗期间一定要密切监测肝功能情况，病毒载量指标不是引起肝功能异常的最直接原因，而只是其中的原因之一。

The effect of antituberculosis drugs on the liver function in patients with hepatitis B

Objective To study the effect of antituberculosis drugs on the liver function in patients with hepatitis B. Methods The changes of liver function,drug-induced hepatitis and serious hepatitis in patients with pulmonary tuberculosis were analyzed in 79 with and 23 without positive hepatitis B virus markers. The patients with pulmonary tuberculosis were given the treatment of regimen of antituberculosis drugs. Results There was no statistically significant difference on the emergence and recovery times of hepatic injuries in 37 patients with high and in 42 with low HBV DNA load(P>0.05). But,the hepatic injuries occurred earlier,and recovered later in patients with HBV marker positive,as compared with 23 patients with HBV marker negative(P<0.05). There were no statistically significant difference as repect to the drug-induced hepatitis and/or serious hepatitis in patients with high and in with low HBV DNA load,but the incidence rate was higher than in patients without HBV infection(P<0.05=. Conclusion In antituberculotic therapy,the liver function tests must be monitored exactly. [