肺结核患者抗结核药物引起肝损害的临床特点分析

目的探讨应用抗结核药物所致药物性肝损害的临床特点，为临床预防和治疗提供理论依据。方法回顾我院2010年10月～2013年10月收治的474例肺结核患者的临床资料，分析发生肝损害患者的临床特点。结果474例患者抗结核药物引起肝损害52例（10．97％）。60岁以上肺结核患者肝损害患病率明显高于60岁以下者，复发肺结核患者肝损害患病率明显高于初发患者，HBsAg阴性患者肝损害患病率明显低于阳性患者，在疗程开始3个月内患者发生肝损害率高于3个月后，差异均有统计学意义（P〈0．05）。男性患者肝损害发生率11．26％，与女性10．50％相似，差异无统计学意义（P〉0．05）。肝损害患者经过保肝治疗，均获得良好的治疗效果。结论高龄、复发、HBsAg阳性及疗程开始3个月内是肺结核抗结核药物治疗发生肝损害的高危人群及时间，应密切观察患者肝功能，做到早发现、早预防和早治疗，有助于顺利完成抗结核化疗疗程。

Clinical Characteristics of Liver Damage Induced by Anti-tuberculosis Drugs for Tuberculosis Patients

Objective To explore the the clinical characteristics of liver injury caused by anti-tuberculosis drugs, and provide theoretical basis for clinical prevention and treatment. Methods Review clinical data of 474 patients with tuberculosis admitted from October 2010 to October 2013, and analyze the clinical characteristics of whom whose liver were damage. Results There were 52 cases of 474 cases patients with liver damage caused by anti-tb drugs （10.97%）. The incidence of liver damage in patients older than 60 years was significantly higher than that of the younger than age of 60 years old, and that of the relapse tuberculosis patients was significantly higher than that of the incipient, that of HBsAg negative patients was significantly lower than the HbsAg positive patients, that of the beginning 3 months of the treatment was higher than that of 3 months later, which suggested statistically significant （P 〈 0.05）. Incidence of liver damage of men was 11.26%, was similar with that of the women which is 10.50%, without statistically significant difference （P〉 0.05）. After protecting liver treatment the patients with liver damage obtained good therapeutic effect. Conclusion The older, beginning 3 months of the treatment, HBsAg positive, recurrence were the highrisk factors of liver damage caused by anti-tuberculosis drugs, should closely observe patients＇ liver function, so as to early detection, early prevention and early treatment, help to complet the anti-tuberculosis chemotherapy regimen successfully.