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目的:研究抗结核药物引起的肝损害对肺结核治疗的影响及相应对策。方法:对18例抗结核期间天门冬氨酸转氨酶(AST)值为正常值上限(ULN)2～6倍的患者,均给予保肝治疗,其中13例AST为2×ULN～4×ULN患者,维持原方案治疗,5例AST为4×ULN～6×ULN患者,将利福平改为利福喷丁治疗。结果:17例患者完成化疗,仅1例AST为5×ULN的老年男性复治患者因出现恶心、食欲不振和黄疸中止化疗。结论:如AST<6×ULN而无其他毒副反应,抗结核治疗可继续进行,加用保肝治疗,AST可恢复正常。
Objective: To study the impact of anti-TB drug-induced liver damage on the treatment of pulmonary tuberculosis and the corresponding countermeasures. Methods: 18 patients with aspartate aminotransferase (AST) value 2-6 times upper limit of normal (ULN) during anti-tuberculosis treatment were treated with liver protection. Thirteen patients with AST were 2 × ULN ~ 4 × ULN patients , To maintain the original plan of treatment, 5 cases of AST 4 × ULN ~ 6 × ULN patients, the rifampin was changed to rifapentine treatment. Results: In the 17 patients who underwent chemotherapy, only 1 patient with remission of nausea, loss of appetite and jaundice was treated with chemotherapy in elderly male patients with AST of 5 × ULN. Conclusion: If AST <6 × ULN but no other side effects, anti-TB treatment can continue, plus liver treatment, AST can return to normal.