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正我国是乙型肝炎高发地，乙肝病毒（HBV）阳性携带者约占总人口的5．3％～12％，同时肺结核也是一个严重的全球性公共卫生问题。我国是全世界22个结核病高负担国家之一，近年结核病的发病率呈明显上升趋势，并且耐药性结核杆菌相当常见。全国调查表明，我国有近6亿人口感染了结核杆菌，占总人口的45％，每年的发病人数120万，因此，在临床上肺结核患者合并HBV感染现象较为常见。目前，国内外对初治菌阳性肺结核推荐2HRS（E）Z/4HR短程化疗方案，除链霉素外，方案中其他药物几乎都有不同程度的肝毒性作用，尤其是在强化治疗期开始的2～3个月，用药较多，3～4种抗结核药物同时联合应用，更易发生肝脏损害。有报道，乙肝表面抗原（HBsAg）阳性肺结核患者化疗中肝损害发生率为50％。因此在临床治疗过程中，了解这部分患者抗结核治疗中出现的肝损害情况对肺结核的治疗具有非常重要的意义。目的观察抗病毒和护肝治疗对乙肝病毒感染合并肺结核患者在抗结核治疗过程中的临床作用。方法选择92例乙肝病毒感染合并肺结核患者，随机分为两组：抗病毒治疗＋抗结核治疗组（抗病毒组）、护肝治疗＋抗结核治疗组（护肝组），观察治疗后肝功能变化情况，结果抗病毒组的患者肝功能水平较护肝组明显降低（P＜0．05）。结论抗病毒治疗能抑制乙肝病毒的复制，防止乙肝病情的加重，从而明显减轻乙肝合并肺结核患者抗结核过程中出现的肝脏功能损害情况。“,”is our country is a high incidence of hepatitis b,hepatitis b virus (HBV)positive carriers accounted for about 5.3% ~12% of the total population,and TB is a serious global public health problem.In our country is one of the 22 high TB burden countries in the world,the obvious rise trend in recent years,the incidence of TB,and drug-resistant TB bacil i is fairly common.National survey shows that our country has a population of nearly 600 mil ion infected with mycobacterium tuberculosis,45% of the population,the number of 1 .2 mil ion a year,therefore,in clinic is common phenomenon of tuberculosis patients complicated by HBV infection.At home and abroad at present,the bacteria positive tuberculosis treated first recommen-ded 2 HRS (E)Z /4 hr dots program,in addition to streptomycin,in almost al other drugs have dif erent degrees of hepatic toxic ef ect,especial y in the intensive treatment period began to 2 ~3 months,drug use is more,3 ~4 kinds of anti-tb drugs and combined application of liver damage are more likely to occur.Reports,hepatitis b surface antigen (HBsAg)positive tuber-culosis incidence of liver damage in patients with chemotherapy was 50%.Therefore in the process of clinical treatment,to understand this part of anti-tuberculosis treatment in patients with liver damage arising from the situation is very important for the treatment of tuberculosis.Objective to observe the antiviral and protect liver treatment of hepatitis b virus infection merged tubercu-losis patients in the clinical ef ect in the process of anti-tuberculosis treatment.Methods choose 92 cases of hepatitis b virus (HBV)infection,amalgamative tuberculosis patients were randomly divided into two groups:antiviral treatment +anti-tuberculosis treatment group (group of antiviral),protect liver treatment +anti-tuberculosis treatment group (group)that protect liver, observe the changes in liver function after treatment,the results antiviral levels in patients with liver function is protect liver group significantly decreased (P <0.05 ).Conclusions antiviral treatment can inhibit the replication of the hepatitis b virus,prevents hepatitis b disease aggravating,thus significantly reduce hepatitis b combined TB tuberculosis in the process of liver function damage.