抗结核药所致药物性肝损伤80例临床分析

Clinical analysis of anti-tuberculosis drug-induced liver injury in 80 patients

目的观察抗结核药导致的药物性肝损伤的临床特点并探讨相关因素。方法回顾性分析汕头市中心医院于2008年6月至2013年6月期间收治并确诊的751例肺结核患者中出现药物性肝损伤的80例患者的临床资料。结果 80例药物性肝损伤与年龄、饮酒史、乙肝病毒携带、治疗方案有关。年龄>60岁占58.8%(47/80)。且患者年龄越大药物性肝损伤发生率越高,有饮酒史占47.5%(38/80),乙肝病毒携带占45.0%(36/80)。异烟肼、利福平、吡嗪酰胺、乙胺丁醇等药物治疗方案比较显示,四联抗结核治疗致药物性肝损伤发生率最高(50.0%)。结论抗结核药能对肝脏造成不同程度的损伤,及早发现、及时治疗均能迅速恢复正常且预后良好。

Objective To investigate the prevalence situation and clinical characteristics of hepatic injury induced by antituberculosis drugs.Methods The clinical data of tuberculosis patients who were treated in June 2008 to June 2013 were collected in this research and analyzed retrospectively for the clinical characteristics of drug induced liver injury and related factors.Results Drug-induced liver injury caused by anti-TB drug is related to alcohol consumption,hepatitis B virus carrier,treatment options and patient age and so on.It is significant that hepatitis B virus carriers and the elderly have a higher incidence of drug induced liver injury（P〈0.05）.Conclusion Anti-TB drugs can cause varying degrees of damage to the liver,early detection and timely treatment can quickly return to normal and the prognosis is good.