在目前常用的抗结核药物中,除链霉素、卡那霉素、卷须霉素、紫霉素和环丝氮酸外,都可以引起程度不同的肝损害,特别是大剂量用药或肝脏原来已有疾病的情况下,易增加药物的毒性。因此,了解并警惕这种药物对肝脏的影响具有重要临床意义。本文就常用抗结核药物对肝脏的影响作一概述,以供参考。异烟肼(INH) 长期用INH的病人约15％发生肝损害,其中严重损害者占0.5％,黄疸的发生率为0.1～1％。肝活检可见肝脏有局限性坏死及炎症。停药或减量可望恢复。已知INH在肝内经N-Z酰转移酶的作用生成乙酰异烟肼,进而转化成乙酰肼,后者再进一步被代谢成活性中间产物,并与肝细胞共 In the currently used anti-TB drugs, except for streptomycin, kanamycin, nymphycin, viomycin and cyclosilazane, all can cause different degrees of liver damage, especially high-dose drugs or the original liver Already the case of disease, easy to increase the toxicity of drugs. Therefore, to understand and be alert to the impact of this drug on the liver has important clinical significance. This article commonly used anti-TB drugs on the liver for an overview of the impact for reference. Isoniazid (INH) INH patients with long-term use of about 15% of liver damage occurred, of which 0.5% of serious damage, the incidence of jaundice 0.1 to 1%. Liver biopsy shows limited liver necrosis and inflammation. Withdrawal or reduction is expected to resume. It is known that INH is converted to acetyl isoniazid by the action of N-Z acylase in the liver, which in turn is converted to acetohydrazide, which is further metabolized to the active intermediate and is co-incubated with hepatocytes