抗结核药物诱导肝损伤的临床分析

Clinical Analysis of the Anti-tuberculosis Drug-induced Liver Injury

目的分析抗结核药物诱导的肝损伤的临床情况。方法采用横断面调查的方法,对2005年3月1日～2007年2月1日在江门市结核病防治所进行抗结核治疗并符合研究标准的结核病人抗结核治疗中的肝功能情况进行总结分析。结果抗结核药物诱导肝损伤的发生率为33.0%。190例(81.9%)发生在90天内。59例患者出现相关肝炎症状。其中胃纳差和恶心、呕吐症状最常见,出现频率分别为67.8%和55.9%。死亡2例,病死率为0.9%。52例需要停药或修改方案,175例患者经过积极治疗肝功能正常或好转。结论结核病患者发生抗结核药物诱导的肝损伤发生率较高,应该引起重视。

Objective To analyze the epidemical characteristics of the antituberculosis drug-induced liver injury. Methods A cross-sectional study design was conducted to investigate the prevalence of the drag-induced liver injury among tuberculosis patients treated in Jiangmen antitubereulosis station during the period from March 1,2005 to February 1,2007. Results There were 232（or 33.0%） cases who were demonstrated antituberculosis drug-induced liver injury. 190 patients developed the reaction within 90 days, accounting for 81.9%. Of the 232 cases,59 emerged related hepatitis symptoms. Anorexia,nausea and vomiting were the most frequent manifestations,accounting for 67.8% and 55.9%, respectively. 52 cases（22.4%） needed to alternate or discontinue the regimens, two died of drug - in- duced liver injury with fatality rate 0.9%. 175（75.4%） experienced normalization or markedly improved of the liver function. Conclusion Liver injury induced by antituberculosis drugs is a severe problem which should be attentive by clinician.