抗结核药致肝损害的研究进展

Reaserch progress of anti-tuberculosis drugs induced hepatotoxicity

tuberculosis药物性肝病(drug induced hepatotoxicity,DIH)以抗结核药诱导的肝毒性(anti-tuberculosis drugs induced hepatotoxicity,ATDH)较常见,其对人体影响最大,是导致结核病人停止化学治疗最常见的原因之一。ATDH的发病机制尚不十分清楚,但目前以毒性反应及特异质反应研究较多,其危险因素包括高龄、女性、慢乙酰化状态、营养不良、人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染、肝疾病、过多摄入酒精,联合用药等。对ATDH的早预防、早发现、早诊断、早治疗是顺利完成结核化疗的保障。因此,了解ATDH的发病机制及危险因素显得至关重要,加强ATDH的防治是一个亟需解决的临床问题。

Drug induced hepatotoxicity（DIH）,especially the anti-tuberculosis（anti-TB） drugs induced hepatotoxicity（ATDH）,impacts greatly on hunman body,and is one of the most common causes of stoping chemotherapy in tuberculosis patients.The pathogenesis of ATDH is not very clear,but the toxicity and idiosyncratic reaction have been widely studied.Its risk factors are as follows：old age,female,slow acetylation status,malnutrition,human immunodeficiency virus infection,liver diseases,excessive intake of alcohol,combination therapy,and so on.Of ATDH,the early prevention,detection,diagnosis,and treatment will be helpful to successfully complete the tuberculosis chemotherapy.Therefore,it is crucial to understand the pathogenesis and risk factors of ATDH and it is urgent to strengthen the prevention of ATDH.