摘要
回顾性分析首都医科大学附属北京胸科医院2010年1月至2014年12月期间收治的55例因抗结核药物所致重度药物性肝损伤（drug-induced liver injury，DILI）患者的治疗方案、治疗药物、发生时间、严重程度、临床表现及转归等情况。55例患者中，男28例（50．2％），女27例（49．1％），平均年龄（41．4±17．9）岁。导致DILI的药物中，明确丙硫异烟胺所致14例，吡嗪酰胺所致9例，利福平所致4例，对氨基水杨酸1例，利福喷丁2例，利福布丁1例，吡嗪酰胺＋利福平联合23例，对氨基水杨酸十吡嗪酰胺1例。调查对象中，重度DILI发生在应用抗结核药物治疗累计2周内24例（43．6％），4周内36例（65．5％），8周内48例（87．3％）；45例（81．8％）有恶心、食欲下降或腹胀不适。除1例死亡外，其余患者经停药保肝等治疗后，肝功能均逐步恢复正常。调查结果提示，对于抗结核治疗方案中含有能够导致肝损伤药物的结核病患者，应警惕其发生重度DILI，定期监测，尽早发现和治疗。
Fifty-five tuberculosis patients with drug induced severe liver injury （DILl） from Jan. 2010 to Dec. 2014 in Beijing Chest Hospital, Capital Medical University were retrospectively analyzed. The treatment, sus- pected drugs, time of onset of severe DILI, severity, clinical manifestations and prognosis were analyzed. Of the 55 cases （28 males （50.2%） and 27 females （49.1%） with mean age of （41.44-17.9） years）, 14 cases were caused by prothionamide, 9 cases were caused by pyrazinamide, 4 cases were caused by rifampiein, 2 cases were caused by ri fapentine, 1 case was caused by amino salicylic acid and 1 case was caused by rifabutin; in addition, 23 cases were caused by pyrazinamide＋rifampicin and one was caused by amino salicylic acid＋pyrazinamide. After taking anti-tu- berculosis drugs, severe DILl occurred in 24 cases （43.6%） within 2 weeks, 36 cases （65.5%） within 4 weeks, and 48 cases （87.3%） within 8 weeks; nausea, decreaced appetite or abdominal distension were found in 45 cases （81.8%）. Recovery of liver function occurred in 54 case, after stopping the suspected drugs and protecting liver function, while 1 case died. It suggested that all the tuberculosis patients using drugs, which inducing liver injury, had the risk of severe DILl, therefore, regularly monitoring, early diagnosis and early treatment were needed.
出处
《中国防痨杂志》
CAS
2016年第6期504-506,共3页
Chinese Journal of Antituberculosis
关键词
结核
药物疗法
药物性肝损伤
Tuberculosis
Drug therapy
Drug-induced liver injury
