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目的 探讨利福平影响凝血因子的临床特点。方法 选择肝功能正常的颈淋巴结结核病患者７３ 例，采用２ Ｈ Ｒ Ｚ Ｓ／１０ Ｈ Ｒ Ｅ 方案，在服药期间监测不同阶段患者血浆凝血酶原时间（ Ｐ Ｔ） 、活动度（ Ｐ Ａ） 、纤维蛋白原（ Ｆ Ｉ Ｂ） 含量、肝促凝血活酶试验（ Ｈ Ｐ Ｔ） 、部分凝血因子活性以及丙氨酸转氨酶（ Ａ Ｌ Ｔ） 。结果 ４８ 例（６６ ％ ） 患者在服药后５ ～３０ 天出现凝血酶原时间延长，部分凝血因子活性降低。凝血因子影响程度与利福平剂量和使用期有关。在第１０ 个月时本组患者 Ａ Ｌ Ｔ 为（１８ ±１２） Ｕ／ Ｌ，但 Ｐ Ｔ为（１９２ ±３９） ｓ， Ｆ Ｉ Ｂ为（１８ ±０５） ｇ／ Ｌ。结论 利福平对维生素 Ｋ 依赖因子和非维生素 Ｋ 依赖因子均有影响，肝损害时不但凝血因子合成减少且凝血因子活性减低。在对肝实质损害的评价中，凝血因子的变化比转氨酶变化更为灵敏，更全面。再次使用利福平和治疗后期时 Ａ Ｌ Ｔ 在正常范围，而凝血因子持续下降，应酌情考虑对策。
Objective To investigate the clinical characteristics of rifampicin-affecting coagulation factors. Methods Totally 73 patients with normal liver function with cervical lymph node tuberculosis were enrolled in this study. Prothrombin time (P T), activity (P A) Fibrinogen (F I B) content, hepatic thromboplastin test (H P T), partial clotting factor activity, and alanine aminotransferase (ALT). Results In 48 patients (66%), the prolonged prothrombin time and the partial coagulation factor activity decreased 5 to 30 days after taking the medicine. The influence of clotting factor is related to the dose and the use period of rifampicin. At 10 months, the A L T was (18 ± 12) U / L, but the P T was (192 ± 39) s, F I B was (8 ± 05) g / L. Conclusions Rifampicin has effects on both vitamin K and non-vitamin K-dependent factors. In liver damage, not only the synthesis of blood coagulation factors but also the activity of coagulation factors are reduced. In the assessment of parenchymal damage, changes in clotting factors are more sensitive and more comprehensive than transaminase changes. Re-use of rifampin and later treatment of A L T in the normal range, and coagulation factors continued to decline, as appropriate, consider countermeasures.