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目的了解我国抗结核治疗导致各种药物不良反应尤其是肝损害的发生率情况。方法于2006年采用系统综述方法,以“结核+药物”为关键词搜索国内发表于1996至2005年的文献,对文献的报道内容进行综合分析,包括抗结核治疗引起的各种不良反应的发生情况、发生率、可能的影响因素及不良反应预后等。结果根据检索结果、入选及排除标准,共纳入文献117篇。近10年文献报道抗结核药物引起的不良反应合计发生率为12.62%,其中以肝损害的报告发生率最高,合计发生率为11.90%。不同诊断标准、不同性质研究单位、不同研究类型报道的肝损害发生率有区别,但前两者无统计学意义。回顾性队列研究证明乙型肝炎病毒标志物阳性或曾有肝病史的结核病患者,其肝损害发生率明显高于一般结核病患者。肝损害的转归较好,在报告了转归的文章中,85.84%的患者不良反应治愈。结论我国抗结核治疗导致各种药物不良反应尤其是肝损害的发生率较高,应重视对不良反应的防治,以增强患者服药的依从性。
Objective To understand the incidence of adverse reactions of various drugs, especially liver damage caused by anti-TB therapy in our country. Methods In 2006, the systematic review method was used to search the literature published in China from 1996 to 2005 with the key words of “nodules + drugs”, and comprehensively analyzed the reported contents of the articles, including various adverse reactions caused by anti-TB treatment Occurrence, incidence, possible factors and prognosis of adverse reactions. Results According to the results of the search, inclusion and exclusion criteria, a total of 117 articles were included. Nearly 10 years reported in the literature of the total incidence of adverse reactions caused by anti-TB drugs was 12.62%, of which the highest incidence of liver damage reported, the total incidence was 11.90%. Different diagnostic criteria, different types of research units, different types of studies reported the incidence of liver damage are different, but the former two have no statistical significance. Retrospective cohort studies showed that the incidence of liver damage was significantly higher in patients with tuberculosis who had a positive history of hepatitis B virus infection or a history of liver disease than in those with a general history of tuberculosis. The prognosis of liver damage is better, in the report of the outcome of the article, 85.84% of patients cured of adverse reactions. Conclusion The incidence of adverse reactions of various drugs, especially liver damage caused by anti-TB therapy in our country is high. Prevention and treatment of adverse reactions should be emphasized in order to enhance compliance of patients with medication.