HBsAg阴性和阳性肺结核患者化疗中肝损害的比较

目的:对比HBsAg阴性和阳性肺结核患者应用抗结核药物治疗后肝损害的情况。方法:对1056例用短程化疗方案2H3R3Z3E3/4H3R3治疗的肺结核患者采集静脉血进行肝功能监测。结果:ALT升高发生率HBsAg(-)组为10.6%,HBsAg(+)组为33.0%,两组比较呈极显著性差异(P<0.01)。肝损害在1个月内出现者HBsAg(-)组为59.3%,HBsAg(+)组为82.8%,两组比较呈极显著性差异(P<0.01)。肝功能在2个月内恢复正常者HBsAg(-)组为93.4%,HBsAg(+)组为67.2%,两组比较呈极显著性差异(P<0.01)。结论:肺结核患者化疗中HBsAg(+)者比HBsAg(-)者更易发生肝损害,且HBsAg(+)者肝损害出现快而肝功能恢复慢。肺结核患者化疗中应加强肝功能监测,尤其对于HBsAg(+)患者应加强护肝。

The Contrast on Liver Injury in Chemotherapy between of HBsAg-Negative Tuberculosis Sufferers and of HBsAg-Positive Ones

Objective: To contrast liver injury after being applied anti-tubercle drugs treatment between of HBsAg-negative tuberculosis sufferers and of HBsAg-positive ones.Methods: Take liver function test on 1056 tuberculosis sufferers who were treated with shortcourse chemotherapy project of 2H3R3Z3E3/4H3R3.Results: Ratio of ALT going up was 10.6% in HBsAg(-) group and 33.0% in HBsAg(+) group.There was significant difference between two groups(P<0.01).Ratio of liver injury happening within a month was 59.3% in HBsAg(-) group and 82.8% in HBsAg(+) group.There was significant difference between two groups(P<0.01).Ratio of liver function recovering within two months was 93.4% in HBsAg(-) group and 67.2% in HBsAg(+) group.There was significant difference between two groups(P<0.01).Conclusion: Chemotherapy injures liver of HBsAg-positive tuberculosis sufferers easier than of HBsAg-negative ones.Liver injury appears quickly but liver function recovers slowly in HBsAg-positive ones.Liver function monitor should be strengthened for tuberculosis sufferers in chemotherapy,especially for HBsAg-positive sufferers it should be strengthened to protect liver.