摘要
目的:探讨两种化疗方案治疗初治涂阳肺结核合并慢性肝病的疗效及安全性。方法:选取2017年3月—2018年5月收治的106例初诊涂阳肺结核合并慢性肝病患者,按随机数表法分为对照组和观察组,每组53例。对照组给予异烟肼、利福平、吡嗪酰胺及乙胺丁醇(2HRZE/4HR)方案化疗,观察组给予异烟肼、利福喷汀、吡嗪酰胺及乙胺丁醇(2HLZE/4HL)方案化疗,比较两组患者临床疗效(痰菌转阴率、病灶吸收率)、药物性肝损伤发生率及损伤程度。结果:化疗后,观察组痰菌转阴率、病灶吸收率(77.36%、73.58%)与对照组(71.70%、67.92%)比较,差异无统计学意义(P>0.05);化疗2周后,观察组肝功能损害率(9.43%)与对照组(11.32%)比较,差异无统计学意义(P>0.05);化疗4周和8周后,观察组肝功能损害率(20.75%、22.64%)低于对照组(39.62%、47.17%),差异有统计学意义(P<0.05)。结论:2HRZE/4HR、2HLZE/4HL化疗方案治疗初治涂阳肺结核合并慢性肝病的痰菌转阴率、病灶吸收率差异无统计学意义,但后者化疗方案肝损害的发生率更低,安全性更高。
Objective:To investigate the efficacy and safety of two chemotherapy regimens in the treatment of smear-positive pulmonary tuberculosis with chronic liver disease.Methods:All 106 newly diagnosed smear-positive pulmonary tuberculosis patients with chronic liver disease in our hospital from March 2017 to May 2018 were selected as the research objects.According to the random number table method,they were divided into control group and observation group,with 53 cases in each group..The control group was given 2HRZE/4HR(isoniazid,rifampicin,pyrazinamide and ethambutol)regimen chemotherapy,while the observation group was given 2HLZE/4HL(isoniazid,rifapentine,pyrazinamide and ethambutol)regimen chemotherapy.The clinical efficacy(sputum negative rate,focus absorption rate),incidence of drug-induced liver injury and degree of injury were compared between the two groups.Results:After chemo-therapy,there was no significant difference in sputum negative conversion rate and focus absorption rate(77.36%,73.58%)between the observation group and the control group(71.70%,67.92%)(P>0.05);after 2 weeks of chemotherapy,there was no significant difference in liver function damage rate between the observation group(9.43%)and the control group(11.32%)(P>0.05);after 4 weeks and 8 weeks of chemotherapy,the liver function damage rate of the observation group(20.75%,67.92%)was no significant difference.22.64%was lower than that of the control group(39.62%and 47.17%,P<0.05).Conclusion:There is no significant difference in sputum negative conversion rate and focus absorption rate between 2HRZE/4HR and 2HLZE/4HL chemotherapy regimens for smear-positive pulmonary tuberculosis with chronic liver disease,but the latter regimen has lower incidence of liver damage and higher safety.
作者
张亚平
ZHANG Yaping(First Affiliated Hospital of Henan University of Science and Technology,Luoyang,471000,China)
出处
《临床医药实践》
2019年第9期663-665,共3页
Proceeding of Clinical Medicine
关键词
肺结核
慢性肝病
利福平
利福喷汀
疗效
肝损害
tuberculosis
chronic liver disease
rifampicin
rifapentine
efficacy
liver damage
