“DOTS—项目”化疗方案版式抗结核药致肝损害44例治疗临床观察

Chemotherapy regimens “DOTS-project” format 44 Anti-tb Drugs Cause Liver Damage Treatment Clinical Observation

目的:探讨结核病"DOTS—项目"化疗方案版式抗结核药致肝损害的辅助治疗,使之安全有效的完成结核病化疗全过程。方法:选择"DOTS—项目"正在用版式结核药治疗中出现"(DLL)(1ULN<ALT<7ULN,Tbil<2ULN)的结核病病人44例,其中初治涂阳病人16例,复治涂阴28例;给予常规护肝降酶治疗,定期复查肝功能(1、2、4周)。结果:42例完成抗结核化疗全疗程完成率95.5%,其中2例因ALT>240U/L,而停用利福平和吡嗪酰胺。而继续使用异胭肼、盐酸乙胺丁醇,并注射链霉素继续完成疗程。结论:注意肝功能的随时变化情况,结合护肝降酶进行治疗,可以帮助因为抗结核治疗而引起的肝功能损害的患者完成抗结核化疗治疗。

objective:to explore tuberculosis chemotherapy regimens'DOTS-project'format anti-tb drugs to aid in the treatment of liver damage process is safe and effective completion of tuberculosis chemotherapy.Methods:select'DOTS-project'is using the format in TB drug therapy'(DLL)(1ULN< ALT<7ULN,Tbil<2ULN)of 44 cases of tuberculosis patients,including 16 cases of initial smear-positive patients,28 cases recurrent smear-negative;methods:routine protect liver to fall enzymatic treatment,liver function periodic review(one week,two weeks,four weeks).Results:42cases of complete all anti-tuberculosis chemotherapy treatment completion rate of 95.5%,among them 2cases because the ALT>240U/L,and stop using rifampicin and pyrazinamide.And continue to use different Yan hydrazine,ethambutol hydrochloride,and injected streptomycin continue to complete the course.Dose,and management style:'DOTS-project'chemotherapy regimens 2h3E3R3Z3/4h3r3 format TB medicine one day in the morning on an empty stomach,the large one-time dose.Rifampin 0.6,isoniazid 0.6,pyrazinamide 2.0,ethambutol hydrochloride 1.25.The scheme for TB medication treatment one-time blood drug concentration is higher,the effect is better.But at the same time also on liver toxic compound,are more likely to cause liver damage.For the whole supervisory management way,build complete medical record and take the medicine,liver damage,such as data record,in accordance with the requirements of project patient supervision and review.conclusion:close observation of liver function change at the same time to protect liver enzyme treatment,can safely and effectively make the vast majority,liver damage caused by anti-tuberculosis treatment of patients with complete anti-tuberculosis chemotherapy regimen.