抗结核药物引起肝功能损害及其他不良反应的动态监测

Dynamic Monitoring of Anti-TB Drug-induced Liver Function Damage and Other Adverse Reactions

目的动态监测肺结核患者的抗结核药物引起肝功能损害及其他不良反应发生率及其影响因素。方法用前瞻性研究方法系统地观察我院2年内诊治的所有初治涂阳肺结核患者抗结核药物引起肝功能损害及其他不良反应发生率及其影响因素。结果84例肝功能损害及265例其他不良反应;肝功能轻度异常52例(4.96%),中度异常26例(2.48%),重度异常6例(0.57%)。265例不良反应中,发热96例(9.16%),有胃肠道症状、恶心、呕吐61例(5.82%),血尿酸增高32例(3.05%),头晕19例(1.81%)、皮疹12例(1.14%),其他24例(2.29%)。结论抗结核药易引起药物性肝炎,用药期间应注意肝功能检测及其他不良反应,对存在高危因素的患者应注意用药。

Objective To dynamically monitor the incidence and influencing factors of anti-TB drug-induced liver function damage and other adverse reactions in TB patients. Methods A prospective analysis was made to systematically observe the incidence and influencing factors of anti-TB drug-induced liver function damage and other adverse reactions of all newly smear-positive TB patients treated in the past two years at our hospital. Results Eighty-four cases showed damages to liver functions including 52 cases（4.96% ） of mildly abnormal liver function, 26 cases（2.48% ）of moderate abnormality, 6 cases（0.57% ）of severe abnormality , and 265 cases of other adverse reactions including 96 cases of fever（ 9.16% ）, 61 cases（5.82% ）of gastrointestinal symptoms, nausea and emesis, 32 cases（ 3.05% ）of increased blood uric acid, 19 （1.81%）cases of dizziness, 12 cases（ 1.14% ）of skin rash and 24 other cases （2.29%）. Conclusion Anti-TB drugs easily cause drug-induced hepatitis. It is important to examine liver functions and other adverse reactions during the period of medication. Individualized medication is necessary for the patients with high-risk factors.