硫普罗宁对乙肝病毒标志物(HBsAg)阳性的肺结核患者化疗所致肝损害的防治作用观察

Prevention and cure effect observation on tiopronin for lungers with positive of hepatitis B virus marker (HBsAg) whose liver injured by chemotherapy

目的观察硫普罗宁对乙型肝炎病毒标志物(HBsAg)阳性肺结核患者化疗所致肝功能损害的防治作用。方法将60例HBsAg阳性合并肺结核患者随机分为治疗组(30例)和对照组(30例),治疗组在患者使用抗结核药物化疗的前2个月给予硫普罗宁片200mg(tid),对照组则不用。治疗期间每周复查1次肝功能。结果治疗组出现药物性肝损害的时间为14～96d,中位52d;对照组为5～56d,中位21d,两组间比较差异有统计学意义(P<0.05)。治疗组的药物性肝损害发生率为13.33%(4例),对照组则为56.67%(17例),两组间比较差异有统计学意义(P<0.05)。结论在HBsAg阳性肺结核患者化疗强化期采用硫普罗宁联合治疗,能降低药物性肝损害的发生率及延缓药物性肝损害的发生时间,保证了HBsAg阳性肺结核患者抗结核药物治疗的顺利进行。

Objective To observe prevention and cure effects of tiopronin for lungers with positive of hepatitis B virus marker （HBsAg） whose liver injured by chemotherapy.Methods Sixty lungers with positive HBsAg were divided into treatment group （30 cases） and control group （30 cases）.Treatment group instead of the control group was provided with 200 mg （tid） tiopronin tablets two months before the chemotherapy with anti-tuberculosis drugs.Liver function reexamination should be conducted once per week during the treatment period.Results The occurrence time of drug-induced liver injury in treatment group was 14-96 days with the midvalue of 52 days;the occurrence time of that in control group was 5-56 days with the midvalue of 21 days.the differences between the two groups were statistically significant （P 0.05）.The incidence of drug-induced liver injury in treatment group was 13.33% （4 cases）,and 56.67% （17 cases） in control group,the differences between the two groups were statistically significant （P 0.05）.Conclusion During the intensive phase of chemotherapy,for lungers with positive HBsAg,tiopronin used in the treatment can reduce the incidence of drug-induced liver injury and delay the occurrence time of drug-induced liver injury,so as to make sure lungers with positive HBsAg are treated by anti-tuberculosis pharmacotherapy smoothly.