低蛋白血症对抗结核药物致药物性肝损害的影响

Influence of hypoproteinemia to drug-induced liver injury during chemotherapy of tuberculosis

目的:探讨不同程度低蛋白血症对结核患者抗结核治疗过程中药物性肝功能损害的影响。方法:对住院治疗合并低蛋白血症的167例初治肺结核患者,根据治疗前血清白蛋白水平(ALB<35 g/L,ALB<30 g/L,ALB<25 g/L)分为轻、中、重三组,为病例组。同期住院治疗的不合并低蛋白血症的初治肺结核患者216例为对照组。结果:对照组出现药物性肝损害率为7.4%,病例组中轻、中、重度低蛋白组出现肝损害率分别为16.3%、35.2%、39.4%,均明显高于对照组。四组之间比较,差异有统计学意义(P<0.05)。四组患者的血清ALB水平与其肝损害率呈负相关(r=-0.973,P=0.027<0.05)。结论:在抗结核的治疗过程中,低蛋白血症使患者药物性肝损害的发生率增高。

Objective To study influence of different hypoproteinemia on drug - induced hepatitis during chemotherapy of tuberculo- sis. Method According to the serum albumin level of prior treatment ALB 〈 35 g/L, ALB 〈 30 g/L, ALB 〈 25 g/L, 167 tuberculous patients with hypopmteinemia,who were hospitalized for initial treatment ,were divided into three subgroups：light, middling and severity. These pa- tients were studied as research group. 216 pulmonary tuberculosis patients without hypoproteinemia,who were also hospitalized during the same period were selected as control group. Results Rate of drug - induced liver injury in control group was 7. 4% ,light was 16.3% ,med- dling was 35.2% ,the severity was 39.4%, showed obviously higher than control group. By statistic analysis, there were significant differences （P 〈 0. 05 ）. There were significant negative correlation between the level of ALB and the rate of drug - induced liver injury （ r = - 0. 973, P = 0. 027 〈 0. 05 ）. Conclusion In antitubereulosis therapy, the rate of drug - induced liver injury, in hypoproteinemia were more than in control group.