血清前清蛋白对抗结核药物肝损害的监测价值

Value of serum prealbumin measurement in monitoring of antituberculosis drugs-induced hepatic lesion

目的了解血清前清蛋白(PA)对抗结核药物肝损害的监测价值。方法 PA采用免疫透射比浊法检测,丙氨酸氨基转移酶(ALT)采用速率法检测,清蛋白(ALB)应用溴甲酚绿法检测。结果结核治疗后亚组血清PA、ALB水平较健康对照组均明显降低(P<0.05),而血清ALT水平较健康对照组明显升高(P<0.05)。结核组治疗后血清PA、ALB、ALT异常率较治疗前明显增高,差异有统计学意义。结核治疗后亚组PA异常率明显高于ALB、ALT异常率,差异有统计学意义。结论血清PA水平监测对抗结核药物何时停药或减量有强烈的预警和指示作用,可作为药物所致早期肝损害监测的理想指标,值得临床推广应用。

Objective To monitor serum levels of prealbumin （PA）, alanine aminotransferase （ALT） and albumin （ALB）, so as to investigate the clinical value of serum prealbumin determination in monitoring of antituberculosis drugs-induced hepatic lesion. Methods PA was determined with transmission turbidimetry, AI.T was measured with rate method, and ALB was measured with bromocresol green method. Results As compared with those of healthy control group, the serum levels of PA and ALB were significantly lower （P〈0.05） and serum level of ALT was markedly higher （P〈0.05） in tuberculosis treatment subgroup. The ab normality rates of PA, ALB and ALT were significantly higher in tuberculosis treatment subgroup than those in tuberculosis non- treatment subgroup. In tuberculosis treatment subgroup, the abnormality rate of PA was remarkably higher than that of ALB and AI.T. Conclusion As a ideal indicator of antituberculosis drugs-induced hepatic lesion, serum prealbumin is worthy of spreading and applying in clinic. Monitoring of serum prealbumin may predict the time of stopping or reducing antituberculosis drugs in treating tuberculosis.