抗结核药物引起的副作用综合报告

Report on side effects of antituberculous agents

目的了解各种抗结核药物引起的副作用并掌握一般处理原则。方法直接或间接证明６２例中由抗结核药物引起的副作用，观察并分析各种副作用分布情况、出现时间及表现形式。结果过敏反应频度占副作用的首位，共３７例，占６０％；严重副反应绝大多数由利福霉素类引起；副作用出现时间多为服药后２个月以内；药物服用过量易导致副反应发生；多种药物可同时或相继产生严重副作用。结论一旦发生严重药物副作用，必须立即停药，及时治疗，否则后果严重；利福霉素类药停药后再服，有可能加重过敏反应程度，故要详细询问既往用药情况，对有肝炎史、酗酒史、药物过敏史和年老体弱者用药过程中要严密观察；对多种药物过敏者，无论反应轻重，以快停药、早脱敏为原则；必须确定过敏原时，要使用常量的１／１０以下，并制定应急处理措施。

Objective To illustrate the side effects of antituberculous agents and the principles to cope with them. Methods Various side effects resulting from antituberculous agents were confirmed directly or indirectly in 62 cases. The distribution, time of presentation, and manifestation of the side effects were observed and analyzed. Results Allergic reaction showed highest frequency in 37 cases (60%). Serious side effects, which were mainly caused by rifamycin agents, occurred within 2 hours after administration. Overdosage tended to increase the occurrence of side effects. Different agents might result in serious side effects at the same time or in succession. Conclusion Once serious side effects appear, the agents causing the effects must be stopped and suitable remedies should be introduced immediately or the consquences might be disastrous. Repeated use of rifamycin agents may aggravate allergic reaction, thus detailed history of previous treatments must be recorded. For patients with hepatitis, allergy history, alcoholics and weak senile patients, close observation is required during the process of treatment. For patients allergic to more than one drug, no matter the reaction is serious or not, the principle is to stop the used drugs and introduce desensitization therapy immediately. If the allergen is to be identified, the testing dosage should be less than 10 per cent of the original dosage, along with prepared procedures for emergen tresale. Repeated tests are not suggested for patients with serious allergic reaction.