抗结核药物致药物性肝损害临床诊治分析

目的总结抗结核药物所致药物性肝炎的临床特点，探讨抗结核药致肝损害的诊断与及其预防和合理的治疗。方法根据临床用药史、临床症状、肝功能检查、影像学检查及药物性肝病诊断标准，对本站2004年至2006年管治的肺结核患者抗结核治疗后出现肝损害的61例患者进行回顾性分析。结果348例结核病人接受抗结核药物治疗后，有61例病人出现药物性肝病，药物性肝病发生率17．53％，348例病人中HBsAg阳性32例，其中13例出现药物性肝损害，占40．63％。结论抗结核药所致肝损害多见于具有危险因素的患者，且多发生在用药的第1～8周。在进行抗结核治疗前应常规检查肝功能、HBsAg，在治疗过程中应定期检查肝功能、对抗结核药致肝损害的早期诊断和及时合理的治疗，可以使患者肝功能恢复正常，帮助患者顺利完成抗结核治疗疗程。

Antituberculosis drug-induced clinical diagnosis and treatment of drug-induced liver injury

Objective To evaluate the anti-tuberculosis drug-induced drug-induced hepatitis clinical characteristics, anti-tuberculosis drug-induced liver injury and its prevention and reasonable diagnosis and treatment. Methods According to clinical drug history, clinical symptoms, liver function tests, imaging examinations and drug-induced liver disease diagnosis and drug-induced liver disease diagnostic criteria of the site from 2004 to 2006 the governance of anti-TB treatment of TB patients after liver injury 61 patients were retrospectively analyzed. Results 348 cases of TB patients receiving anti-TB drugs after treatment, 61 patients the emergence of drug-induced liver disease, drug-induced liver disease incidence of 17.53%, 348 patients in the HBSAG positive for 32 cases, of which 13 cases of the emergence of drug-induced liver injury, accounting for 40.63%. Conclusions The anti-tuberculosis drug-induced liver injury more common in patients with risk factors, and multi-drug use occurred in the first 1 week to the first 8 weeks. Anti-TB treatment during routine examination before liver function, HBSAG, treatment should be regularly checked liver function. Anti-tuberculosis drug-induced liver damage on the early diagnosis and timely and reasonable treatment, can return to normal liver function in patients and help patients with the successful completion of anti-TB treatment regimens.