抗结核病药引起药物性肝损害的研究

Comparison study on drug induced liver diseases during anti-tuberculosis treatment of tuberculosis patients

目的探讨抗结核疗程中加用保肝药的必要性和合理性。方法380例初治肺结核患者分为抗痨治疗的同时加用保肝治疗及抗痨方案相同未加保肝药者进行对照研究。结果病例组合并HBsAg阳性者药物性肝损伤的程度轻中度之比为5/5,大于60岁的老年患者药物性肝炎发生率为20.5%(9/44),肝损伤的轻中度之比为6/3,与对照组相比有显著性差异(P<0.05)。结论对老年性肺结核患者及合并HBsAg阳性者抗痨的同时加用保肝治疗,尤其强化期建议全程使用。而对HBsAg阴性的中青年肺结核患者加用保肝治疗保护作用不明显。

Objective To study the necessity and usefulness of liver-protection drugs applied in the process ot antl-tuberculosls treatment. Method 380 newly diagnosed tuberculosis patients were treated with both anti-tuberculosis and liver-protection drugs at the same time. The results were compared with those control patients receiving the same anti-tuberculosis treatment but without applying liver- protection drugs. Results The degree of drug induced liver damage （ mild versus moderate） for case mix and HBsAg positive patients was 5/5. The occurrence of drug induced liver disease and the degree of drug induced liver damage （mild versus moderate） for elder patients （ 〉60 years old） were 20. 5 % （9/44） and 6/3, respectively. The above results are significantly different from those of the control （P 〈 0. 05 ）. Conclusion It is recommended to apply liver-protection drugs during anti-tuberculosis treatment for elder tuberculosis patients and HBsAg positive patients. Particularly, this treatment method should be applied during the entire strengthening period. However, no statistically significant effect was observed for young to middle aged HBsAg negative tuberculosis patients.