论文部分内容阅读
目的探讨初发肺结核患者抗结核治疗中早期监测肝损伤的方案。方法观察肺结核治疗治疗中早期监测肝损伤的两种方案在判断肝损伤和观察预后的优缺点。一种方案是两项监测法,即监测临床症状、血清谷丙转氨酶(ALT),另一种是三项监测法,即除了监测1临床症状、ALT,同时还检测血清前白蛋白(PA)。结果三项监测法发现抗结核治疗中74%的肺结核患者有肝损伤,1周时发生率为51%,肝损伤后采取加强保肝治疗后停药率为0,全程有效治疗率100%。两项监测法仅能发现27%的肺结核患者有肝损伤,1周时发生率为2%,肝损伤后采取同样的保肝治疗后停药率为16%,全程治疗有效率84%。结论三项监测法能及时发现早期肝损伤。通过采取及时的保肝治疗,结核病人可顺利继续进行抗结核治疗,是临床较理想的监测肝损伤的方案。
Objective To investigate the early detection of liver damage in patients with newly diagnosed pulmonary tuberculosis during antituberculosis treatment. Methods To observe the advantages and disadvantages of two kinds of regimens for the treatment of liver injury during the early and middle stage of tuberculosis treatment in judging the liver injury and observing the prognosis. One option is to monitor the clinical symptoms of ALT, and the other is the three monitoring methods, which monitor the clinical symptoms, ALT, serum albumin (PA) . Results The three monitoring methods found that 74% of tuberculosis patients had liver injury in TB treatment, 51% in 1 week and 0 after stopping liver injury. The effective rate of treatment was 100%. The two monitoring methods only found that 27% of patients with tuberculosis had liver injury, the incidence was 1% at 2 weeks, and the same drug treatment after liver injury was stopped at 16% with 84% of the whole course of treatment. Conclusion Three monitoring methods can detect early liver injury. Through timely treatment of liver, tuberculosis patients can successfully continue the anti-TB treatment, is a clinical ideal program to monitor liver damage.