结核病合并HIV/AIDS患者抗结核治疗中肝损伤情况调查

Investigation of liver injury in antituberculosis treatment of tuberculosis complicated with HIV/AIDS

目的研究抗结核治疗对结核病合并HIV/AIDS患者肝损伤情况。方法临床纳入384例我院2014年1月~2017年1月期间收治的TB患者作为研究对象,所有患者均进行酶联免疫吸附测定法(ELISA)进行人类免疫缺陷病毒(HIV)抗体测定,将其中65例HIV抗体阳性患者作为HIV/AIDS合并TB组,另319例HIV抗体阴性患者作为单纯TB组。两组患者均进行抗结核治疗,观察两组患者肝损伤发生率、肝损伤类型、肝损伤出现时间以及治疗转归情况。结果 HIV/AIDS合并TB组肝损伤发生率为49.23%,明显高于单纯TB组的8.46%(P<0.05)。两组患者肝功能损伤类型均以混合型占比例最多,两组差异无统计学意义(P>0.05)。HIV/AIDS合并TB组患者~4周出现肝损伤明显多于单纯TB组,而单纯TB组更多出现在~8周时,两组对比差异有统计学意义(P<0.05)。HIV/AIDS合并TB组治疗总有效率为71.88%,明显低于单纯TB组的92.59%(P<0.05)。结论 HIV/AIDS合并TB患者抗结核治疗时可能更容易发生肝损伤,影响患者预后,对这类患者需要更加注意。

Objective To explore the effects of antituberculosis therapy on liver injury in patients with tuberculosiscomplicated with HIV/AIDS.Methods The clinical data were collected from384patients with TB treated inour hospital from January2014to January2017.All patients were subjected to enzyme-linked immunosorbentassay(ELISA)to detect human immunodeficiency virus(HIV)antibodies.65patients with HIV antibody positive wereas HIV/AIDS combined with TB group,another319patients with HIV antibody negative were as simple TB group.Allthe patients in the two groups were treated with anti tuberculosis.The incidence of liver injury,the type of liver injury,the time of liver injury and the prognosis of the liver injury of the two groups were compared.Results The incidenceof liver injury in HIV/AIDS combined with TB group was49.23%,which was significantly higher than that in simpleTB groupwith8.46%(P<0.05).Most of liver injury types of the two groups were mixed type,accounting for thelargest proportion,the two groups were no difference(P>0.05).Patients in HIV/AIDS combined with TB group hadliver damage at^4weeks more than those in the simple TB group,however the simple TB group appeared more frequentlyat^8weeks,and there were differences between the two groups(P<0.05).The total effective rate of HIV/AIDS combined withTB group was71.88%,which was significantly lower than that of pure TB group with92.59%(P<0.05).ConclusionPatients with HIV/AIDS combined with TB may be more vulnerable to liver injury during antituberculous therapy.Itaffect the patient prognosis.More attention needs to be paid to such patients.