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目的:探讨412例抗结核药物导致的肝脏损害的危险因素及临床特点。方法:回顾性调查分析2011年8月~2015年9月川东北地区4家三甲医院进行抗结核治疗发生肝损害患者的性别、年龄,临床症状及肝功能指标检测情况,发生肝损害的时间关系,以及肝损害患者的治疗后的转归。结果:4 272例抗结核治疗的患者中出现肝损害的有412例,发生率为9.5%。老年患者肝损害发生率为20.8%(20/96),明显高于非老年患者的9.3%(390/4176)差异有统计学意义(P<0.01)。412例肝损害患者中,318例(77.2%)发生于用药60 d内;300例患者(72.8%)出现典型肝炎临床症状,112例患者(27.2%)无症状;经过治疗后有387例患者(93.9%)好转或痊愈25例患者(6.1%)未愈。结论:老年患者使用抗结核药物导致肝损害的发生率较高,因此,针对老年患者在使用抗结核药物治疗过程应密切监测患者的肝功能,及时调整治疗方案。
Objective: To explore the risk factors and clinical features of 412 cases of liver damage caused by anti-TB drugs. Methods: The gender, age, clinical symptoms and liver function of patients with liver damage after antituberculosis treatment in 4 top three hospitals in northeastern Sichuan from August 2011 to September 2015 were retrospectively analyzed. The time course of liver damage , And outcome after treatment in patients with liver damage. Results: Of the 4 272 patients with anti-TB therapy, 412 developed liver damage, a rate of 9.5%. The incidence of liver damage in elderly patients was 20.8% (20/96), which was significantly higher than that in non-elderly patients (9.3%, 390/4176) (P <0.01). Of the 412 patients with liver damage, 318 (77.2%) occurred within 60 days of treatment; 300 patients (72.8%) developed clinical symptoms of hepatitis and 112 (27.2%) were asymptomatic; after treatment, 387 patients (93.9%) improved or healed 25 patients (6.1%) did not heal. Conclusion: The incidence of liver damage caused by anti-tuberculosis drugs in elderly patients is high. Therefore, the monitoring of liver function in elderly patients during treatment with anti-TB drugs should be promptly adjusted.