抗结核治疗后脂肪肝形成与药物性肝损伤的相关性研究

目的 了解抗结核药物所致脂肪肝和DILI的发生机率与关系.方法 选取200例经结核病防治机构明确诊断为结核病病例为研究对象,分别于抗结核治疗前、后进行肝功能、血脂监测,治疗前及治疗完成时均行肝区CT扫描.结果 抗结核治疗后血清ALT、AST水平均高于治疗前 （P〈0.05）.其中ALT 在治疗后的第1、2、3个月、AST在治疗后的第1、2、3、4个月升高最为明显（P〈0.01）.TG、HDL-C、LDL-C、apoB水平均显著高于治疗前 （P〈0.05）.结论 肝细胞脂肪化病变为DILI的独立危险因素,抗结核治疗中脂肪肝形成则提示DILI已发生.

Research correlation on formation of fatty liver and drug-induced liver injury after anti-tuberculosis therapy

Objective To study the relation and incidence between fatty liver caused by anti-tuberculosis drugs and DILI. Meth- ods 200 patients with tuberculosis （TB） were selected as the research group. Their liver function and blood lipid were respectively moni- tored before and after the anti-TB treatment. Results After the anti-tuberculosis treatment, the serum levels of ALT and AST were signifi- cantly higher than before the treatment （ P 〈 0. 05 ）. The level of ALT increased obviously at the 1 st, 2nd and 3rd months after the treat- ment, and the level of AST increased obviously at the 1st, 2rid, 3rd and 4th months after the treatment （P 〈0. 01 ）. The levels of TG, HDL, LDL-C-C, and apoB were significantly higher after the treatment than before （P 〈 0. 05 ）. Conclusion The independent risk fac- tor is hepatocyte adipose for DILI. The occurrence of fatty liver during anti-tuberculosis treatment indicates that DILl has occurred.