抗结核药物引发肝损伤的影响因素研究进展

Research Progress in Influencing Factors of Liver Injury Caused by Anti-tuberculosis Drugs

我国是结核病高负担国家,结核病患者基数大,抗结核治疗周期长。在抗结核治疗过程中,因联用药物复杂、多样,可能出现各种类型的药物不良反应,其中药物性肝损伤(drug-induced liver injury,DILI)最为多见,危害性也最大,轻者表现为一过性转氨酶升高,重者可致肝衰竭,甚至危及生命,部分患者不得不因此中止抗结核治疗。本文从生活习惯、基础疾病、遗传因素等方面对患者发生抗结核药物性肝损伤(anti-tuberculous drug-induced liver injury,ATB-DILI)的影响因素进行了综述,为临床ATB-DILI的预防和处置提供参考。

China is a country with a high burden of tuberculosis,that is,with a large number of tuberculosis patients,and a long period of anti-tuberculosis treatment.In the course of anti-tuberculosis treatment,various adverse drug reactions may occur due to complex and diverse combination of drugs,of which drug-induced liver injury(DILI)is the most common and most harmful one,with mild cases showing transient elevated transaminases and severe cases leading to liver failure and even life-threatening effects.Therefore,some patients have to discontinue anti-tuberculosis treatment.This article reviews the influencing factors of anti-tuberculous drug-induced liver injury(ATB-DILI)in patients from aspects such as living habits,underlying diseases,and genetic factors,providing reference for prevention and treatment of ATB-DILI in clinical practice.