目的调查抗结核药物致肝损害危险因素,为减少结核病化疗中不良反应的发生率提供依据。方法选择某院2006年1月～2010年12月100例化疗的结核病患者,所有患者均采用2SHR(Z)E/6HRZ化疗方案治疗,治疗期间每月复查肝功能1次。采用非条件Logistic回归模型进行单因素和多因素逐步回归分析。计算各因素的OR值及OR95%可信区间。结果肝损害发生数与治疗时间呈正相关,治疗后3个月肝损害发生率与治疗前比较差异有统计学意义(P﹤0.05)。男性、大于60岁的、有肝炎病史、酒精依赖、糖尿病、营养不良是结核患者发生药物肝损害的高危因素,与正常组比较差异有统计学意义(P﹤0.05)。本组发生药物肝损害的29例患者中,重度肝损害4例,占13.79%,均为男性,且年龄均大于60岁,两种危险因素比较差异有统计学意义(P﹤0.05)。结论在对结核患者药物化疗的同时应定期监测肝功能,同时在制定化疗方案时应充分考虑患者是否具备肝损害的高危因素,最大限度地减少和减轻肝损害的发生。 Objective To investigate the risk factors of liver damage caused by anti-tuberculosis drugs and provide basis for reducing the incidence of adverse reactions in tuberculosis chemotherapy. Methods A total of 100 patients with tuberculosis who underwent chemotherapy from January 2006 to December 2010 in our hospital were selected. All patients were treated with 2SHR (Z) E / 6HRZ chemotherapy. Liver function was reviewed once a month during treatment. Unconditional logistic regression model was used to conduct single factor and stepwise regression analysis. Calculate the OR value of each factor and OR95% confidence interval. Results The number of liver damage and treatment time were positively correlated. The incidence of liver damage at 3 months after treatment was significantly different from that before treatment (P <0.05). Men, older than 60 years old, had a history of hepatitis, alcohol dependence, diabetes and malnutrition were risk factors for liver damage in patients with tuberculosis, which was significantly different from the normal group (P <0.05). Among the 29 patients with hepatic injury, 4 patients (13.79%) had severe hepatic injury, all of whom were male and older than 60 years old. There were significant differences between the two risk factors (P <0.05). Conclusions In the chemotherapy of tuberculosis patients, the liver function should be monitored regularly. At the same time, the patients with high risk of liver damage should be fully considered in the development of chemotherapy regimen to minimize and reduce the occurrence of liver damage.