HIV/TB患者治疗过程中抗结核药物性肝损伤的临床分析

Clinical analysis of antituberculosis drug-induced hepatotoxicity in HIV/TB patients

目的判断和比较HIV阳性和阴性的结核患者抗结核药物诱导肝毒性(antituberculosis drug-induced hepatotonicity,AT-DH)的临床特征。方法收集资料完整的临床病例75例HIV阳性、63例阴性的结核患者,监测ATDH的发生率和临床特征。结果亚临床ATDH发生率为12.3%(17/138),临床ATDH发生率为6.5%(9/138),与HIV阳性、CD4细胞计数降低、联合用药有关。结论HIV患者免疫状态低下时,ATDH是HIV相关TB患者的一个重要问题,应常规监测肝功能和早期发现临床症状。

Objective To analyse the clinical feature of antituberculosis drug-induced hepatotoxicity （ATDH） in HIV/TB patients. Methods Seventy-five HIV positive and 63 HIV negative TB patients were collected in this study. All patients were monitored biochemically and clinically for incidence of ATDH and clinical features. Results The inci- dence of sub-cllnical hepatotoxicity and clinical hepatotoxicity was 12.3% and 6.5% in these patients. The incidence of sub-clinical hepatotoxicity was significantly associated with HIV co-infection （ P 〈 0.05 ） , concomitant drug intake （P 〈 0.05 ） and decrease of CD4 count （P 〈 0.05 ）. Conclusion In the declined immune status of AIDS patients, ATDH is an important problem in HIV-related TB patients, and the liver function should be regularly monitored and clinical symptom should be early discovered.