含吡嗪酰胺抗痨治疗方案的肝毒性临床观察

Clinical Observation of Hepatotoxicity inAntiphthisic Therapy Containing Pyrazinamide.

对203例结核病患者用含吡嗪酰胺(PZA)方案治疗产生肝脏毒性进行分析,发生率为16.7％,较国内外报告的1～5％为高。5种含PZA方案肝毒性反应的发生率无差异(P>0.05),91％肝毒性发生在开始治疗两个月内,绝大多数预后良好。肝功能的GPT100单位以下者多在4周内恢复,100单位及以上者大多需8周以上恢复正常。如伴有黄疸个别可出现严重肝功能损害。提示含PZA方案一般较安全,但应严格掌握含PZA方案的适应症;用药早期要注意作好肝功能监测。

There were 203 cases of tuberculosis treated by anti-phthisic therapy containing Pyrazinamide(PZA) in 1982—1987. The hepatotoxicity of this treatment was observed and analyzed clinically. The rate of incidence was 16.7% and about 1-5% higher than those reported domestically and abroad. Ninetyone percent of the cases developped hepatotoxicity within 2 monthes since the onset of treatment and most of them showed good prognosis. In patients with SGPT<100 units, recovery took place within 4 weeks, and the patients would require 8 weeks for recovery, if their SGPT>100 units. If juandice occurred, it might indicate severe injury of liver function. Thus, the antiphthisic therapy containing PZA is still safe geuerally. Of course, the indicat- ions for this plan with PZA should be controlled strictly. And liver function monitoring will be performed in the early periods of treatment to maintain sharp vigilance and prompt medical management will be needed too.