抗结核同时予保肝治疗预防药物性肝损害的临床意义

Clinical Significance of Antituberculous Combined with Liver Protection Therapy for the Prevention of Drug-induced Liver Injury

目的:分析抗结核同时予保肝治疗预防药物性肝损害的临床意义。方法:选取2012年9月-2014年8月本院收治的80例结核病患者作为研究对象,所有患者均接受规范化抗结核治疗,并根据随机数字表法分为对照组和试验组,每组40例。其中对照组患者抗结核治疗期间未接受保肝治疗,试验组患者抗结核治疗期间同时给予保肝治疗。随访1年以上,对比两组患者抗结核治疗效果和药物性肝损伤发生情况及治疗前后患者ALT、AST、TBIL等肝功能指标的变化。结果:经过数据统计发现,试验组患者的痰培养结果阴转率为75.00%,对照组为70.00%,两组比较差异无统计学意义(P>0.05)。试验组治疗期间的药物性肝损伤发生率2.50%明显低于对照组的20.00%,差异有统计学意义(P<0.05)。对照组治疗后的ALT、AST、TBIL分别为(79.23±11.65)U/L、(83.46±12.31)U/L、(22.58±5.42)μmol/L,均明显高于治疗前的(45.28±9.32)U/L、(50.32±9.51)U/L、(9.58±2.87)μmol/L,差异均有统计学意义(P<0.05)。试验组治疗后的ALT、AST、TBIL分别为(65.15±10.43)U/L、(68.75±11.12)U/L、(18.22±4.93)μmol/L,均明显高于治疗前的(44.83±9.45)U/L、(51.24±9.44)U/L、(9.61±2.90)μmol/L,差异均有统计学意义(P<0.05)。且试验组治疗后的ALT、AST、TBIL等肝功能指标上升幅度明显小于对照组,差异均有统计学意义(P<0.05)。结论:抗结核同时予保肝治疗可有效预防药物性肝损害,对患者的预后有益。

Objective：To analyze the clinical significance of antituberculous combined with liver protection therapy for the prevention of drug-induced liver injury.Method：Eighty patients with tuberculosis admitted to our hospital from September 2012 to August 2014 were selected as the research objects,all patients received standardized antituberculous treatment.They were divided into the control group and the experimental group according to random number table method,40 cases in each group.The control group was not given liver protection therapy during antituberculous treatment,the experimental group was given liver protection therapy during antituberculous treatment at the same time.More than 1 year of follow-up,the antituberculous treatment effect and drug resistance liver injury occurrence,the changes of liver function indexes such as ALT,AST,TBIL before and after treatment between the two groups were compared.Result：After data statistics found that the sputum culture results negative conversion rate of the experimental group was 75.00%,that of control group was 70.00%,there was no statistically significant difference（P〉0.05）.The incidence of drug-induced liver injury of the experimental was 2.50%,which was significantly lower than 20.00% of the control group,the difference was statistically significant（P〈0.05）.The ALT,AST,TBIL of the control group after treatment were（79.23±11.65）U/L,（83.46±12.31）U/L,（22.58±5.42）μmol/L,which were significantly higher than（45.28±9.32）U/L,（50.32±9.51）U/L,（9.58±2.87）μmol/L of before treatment,the differences were statistically significant（P〈0.05）.The ALT,AST,TBIL of the experimental group after treatment were（65.15±10.43）U/L,（68.75±11.12）U/L,（18.22±4.93）μmol/L,which were significantly higher than（44.83±9.45）U/L,（51.24±9.44）U/L,（9.61±2.90）μmol/L of before treatment,the differences were statistically significant（P〈0.05）.The rise range of liver function indexes such as ALT,AST,TBIL in the experimental group after treatment were significantly less than the control group,the differences were statistically significant（P〈0.05）.Conclusion：Antituberculous treatment combined with liver protection therapy at the same time can effectively prevent drug-induced liver injury,beneficial to the prognosis of patients.