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目的 了解抗结核药物对慢性ＨＢＶ 感染者肝功能的不良影响。方法 对住院的ＨＢｓＡｇ 阳性肺结核患者１１０ 例和单纯肺结核患者１２０ 例实施短程化疗方案（２ＳＨＲＺ／４ＨＲＥ），动态观察两组病人的肝功能变化并随访至疗程结束后６ 个月。结果 原先肝功能正常的ＨＢｓＡｇ 阳性患者，大多数（８１－８％ ） 在治疗过程中均能保持肝功能正常，而１８－２ ％ 的患者出现肝功能异常，符合药物中毒性肝炎。停抗结核药后，治疗组ＡＬＴ平均复常时间为２４－４±１７－７ ｄ，对照组为１７－１±１３－８ ｄ（ Ｐ＜ ０－０５）。结论 大多数ＨＢｓＡｇ 阳性的结核病患者，可以耐受的短程化疗方案。但少数患者一旦出现肝损害，恢复较慢。因此，在化疗过程中，必须密切监测肝功能。
Objective To understand the adverse effects of anti-TB drugs on liver function in patients with chronic HBV infection. Methods One hundred and ten patients with HBsAg positive pulmonary tuberculosis and 120 patients with simple pulmonary tuberculosis were enrolled in this study. Short-course chemotherapy (2SHRZ / 4HRE) was used to observe the changes of liver function in two groups of patients and were followed up for 6 months after the end of treatment. Results Most of the original HBsAg-positive patients with normal hepatic function, most of them (81-8%) maintained normal liver function during the course of treatment, while 18-2% patients had abnormal liver function, which was in line with drug-induced hepatitis. After stopping anti-tuberculosis drugs, the average ALT time of the treatment group was 24-4 ± 17-7 days and that of the control group was 17-1 ± 13-8 days (P <0-05). Conclusions Most patients with HBsAg-positive tuberculosis can tolerate short-course chemotherapy regimens. However, a small number of patients in the event of liver damage, recovery is slow. Therefore, in the course of chemotherapy, liver function must be closely monitored.