摘要
目的观察利福喷丁、利福平方案用于初治乙型病毒性肝炎表面抗原(HBsAg)阳性肺结核患者的临床疗效,及对药物性肝损伤的影响。方法将HBsAg阳性肺结核患者依据抗结核治疗方案分为试验组和对照组,试验组接受2HLZE/4HLE抗结核方案(利福喷丁0.6 g、每周2次+异烟肼0.3 g、qd+盐酸乙胺丁醇0.75 g,qd+吡嗪酰胺0.5 g、tid)治疗,对照组接受2HRZE/4HRE抗结核方案(利福平0.6 g、qd+异烟肼0.3 g、qd+盐酸乙胺丁醇0.75 g、qd+吡嗪酰胺0.5 g、tid)。2组疗程均为6个月。比较2组患者的临床疗效、痰菌转阴率、肝功能指标[谷丙转氨酶(GPT)、谷草转氨酶(GOT)、血清总胆红素(TBIL)]水平,药物性肝损伤情况及药物不良反应的发生情况。结果试验组共入组41例患者、对照组共入组39例患者。治疗后,试验组和对照组的总有效率分别为97.56%和79.49%,差异有统计学意义(P<0.05)。治疗后4个月,试验组和对照组的痰菌转阴率分别为90.24%和71.79%;治疗后6个月,试验组和对照组的痰菌转阴率分别为95.12%和79.49%,差异均有统计学意义(均P<0.05)。治疗后6个月,试验组和对照组的GPT水平分别为(87.39±17.26)和(101.49±23.48)U·L^(-1),GOT水平分别为(97.54±19.25)和(119.63±21.57)U·L^(-1),TBIL水平分别为(31.53±9.35)和(38.27±9.64)μmol·L^(-1),差异均有统计学意义(均P<0.05)。试验组和对照组的药物性肝损伤发生率分别为19.51%和41.03%,肝损伤发生时间分别为(12.98±2.26)和(10.23±1.95)d,差异均有统计学意义(均P<0.05)。试验组和对照组的药物不良反应发生率分别为29.27%和64.10%,差异有统计学意义(P<0.05)。结论与利福平方案相比,利福喷丁方案治疗HBsAg阳性肺结核患者能降低药物性肝损伤发生率和损伤程度,进而提高临床治疗效果。
Objective To observe the clinical efficacy of levofloxacin combined with levofloxacin scheme in the treatment of pulmonary tuberculosis patients with positive hepatitis B surface antigen(HBsAg)and its impact on drug-induced liver injury.Methods Pulmonary tuberculosis patients with positive HBsAg were divided into treatment group and control group according to the anti-tuberculosis treatment plan.The treatment group received 2HLZE/4HLE anti-tuberculosis regimen(levofloxacin 0.6 g,twice a week+isoniazid 0.3 g,qd+ethambutol hydrochloride 0.75 g,qd+pyrazinamide 0.5 g,tid)for 6months,and the control group received 2HRZE/4HRE anti-tuberculosis regimen(levofloxacin 0.6 g,qd+isoniazid 0.3 g,qd+ethambutol hydrochloride 0.75 g,qd+pyrazinamide 0.5g,tid)for 6 months.The sputum smear conversion rate,liver function indicators[glutamate pyruvate transaminase(GPT),glutamate oxaloacetate transaminase(GOT),serum total bilirubin(TBIL)],clinical efficacy,druginduced liver injury,as well as the incidence of adverse drug reactions were compared between the two groups.ResultsA total of 41 patients were enrolled in the treatment group and 39 patients in the control group.After treatment,the clinical total effective rates in the treatment and control groups were 97.56%and 79.49%,which showed statistically significant difference(P<0.05).After 4 months of treatment,the sputum smear conversion rates in the treatment group and the control group were 90.24%and 71.79%,respectively;after 6 months of treatment,the sputum smear conversion rates in the treatment group and the control group were 95.12%and 79.49%,respectively,both showing statistically significant differences(allP<0.05).After 6 months of treatment,the GPT levels in the treatment group and the control group were(87.39±17.26)and(101.49±23.48)U·L^(-1),the GOT levels were(97.54±19.25)and(119.63±21.57)U·L^(-1),and the TBIL levels were(31.53±9.35)and(38.27±9.64)μmol·L^(-1),respectively,all showing statistically significant differences(allP<0.05).The incidence of drug-induced liv
作者
宗玲青
高胜利
凌丽华
卫峰
刘艳
叶扬
ZONG Ling-qing;GAO Sheng-li;LING Li-hua;WEI Feng;LIU Yan;YE Yang(Departmentot fInfectioussDiseases,Suzhou Ninth People's Hospital,Suzhou 215000,Jiangsu Province,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2023年第23期3365-3369,共5页
The Chinese Journal of Clinical Pharmacology
关键词
利福喷丁胶囊
利福平胶囊
肺结核
药物性肝损伤
pulmonary tuberculosis capsule
rifampicin capsule
pulmonary tuberculosis
drug-induced liver injury
