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目的探讨抗结核药物对高危险因素人群肝损害的特点。方法选取2009年1月-2010年12月结核病防治科抗结核治疗128例存在高危因素人群患者,依据治疗过程中是否采用护肝治疗措施分为未干预组63例,干预组65例,比较两组患者在抗结核治疗中出现药物性肝损害的时间及临床症状的差异,对比两组间肝损害发生率、肝损情况、引起肝损的原因。结果未干预组肝损害发生率及肝功能受损害程度较干预组高,差异有统计学意义(P<0.05)。两组引起药物性肝损的原因中以利福平为主,出现药物性肝损的时间高峰为服药4周以内、而引起肝损的三种药物的构成比差异无统计学意义(P>0.05)。结论对于老年人、长期饮酒者、乙肝病毒感染者、营养不良等高危险因素人群抗结核治疗时给予干预方案,可以减少肝损发生。
Objective To investigate the characteristics of liver damage caused by anti-tuberculosis drugs in high-risk population. Methods From January 2009 to December 2010, tuberculosis prevention and treatment section of 128 cases of patients with high risk factors for tuberculosis were treated according to whether the treatment of liver protection is divided into intervention group 63 cases, intervention group 65 cases, compared with two Patients in the anti-TB treatment of drug-induced liver damage time and clinical symptoms were compared between the two groups compared the incidence of liver damage, liver damage, the cause of liver damage. Results The incidence of liver damage and liver damage in non-intervention group were significantly higher than those in intervention group (P <0.05). The two groups caused by drug-induced liver damage in the main rifampin-based, drug-induced liver damage peaked within 4 weeks of medication, while the composition of the three drugs that caused liver damage was no significant difference (P> 0.05). Conclusions Intervention programs for anti-TB therapy in the elderly, long-term drinkers, hepatitis B virus infection, malnutrition and other high-risk factors may reduce the incidence of liver damage.