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目的了解艾滋病(AIDS)病人使用保肝药物,对标化四联抗结核(TB)治疗中药物性肝损伤的预防效果。方法回顾性分析采用标化四联抗结核治疗的AIDS合并TB的住院病人(简称AIDS/TB病人),对强化期内使用保肝药物预防(治疗组)与未使用保肝药物预防(对照组)的病人,比较两者药物性肝损伤的发生率。预防使用的保肝药为还原型谷胱甘肽或复方甘草酸苷。有3种以上肝损伤危险因素同时存在的病人,称为肝损伤高危病人。结果符合条件的211例病例中,治疗组122例,肝损伤发生率为13.1%(16例);对照组89例,肝损伤发生率为19.1%(17例);两组比较肝损伤发生率差异无统计学意义(χ2=1.398、P>0.05)。肝损伤高危病人134例,使用保肝药物的86例,肝损伤发生率15.1%(13例),未使用保肝药物的48例,肝损伤发生率为25.0%(12例),两组比较无统计学意义(χ2=1.983、P>0.05)。使用复方甘草酸苷65例,肝损伤发生率为13.8%(9例),使用还原型谷胱甘肽57例,肝损伤发生率为12.3%(7例),两组比较差异无统计学意义(χ2=0.001、P>0.05)。结论 AIDS/TB病人使用保肝药物预防抗结核药肝损伤效果不显著,需灵活掌握治疗方案。
Objective To understand the use of hepatoprotective drugs in AIDS patients to prevent the drug-induced liver injury in patients with standardized quadruple tuberculosis (TB). Methods A retrospective analysis was conducted on inpatients with AIDS combined with TB treated with standardized quadruple anti-TB therapy (AIDS / TB patients). The prevention and treatment of hepatotoxic agents (treatment group) and non-use of hepatoprotective drugs during intensive phase (control group ) Patients, compared the incidence of drug-induced liver injury. Preventive use of hepatoprotective glutathione or compound glycyrrhizin. There are three or more patients with risk factors for liver injury at the same time, known as high-risk patients with liver damage. Results Of the 211 eligible cases, 122 cases in the treatment group had a liver injury rate of 13.1% (16 cases); 89 cases in the control group had a liver injury rate of 19.1% (17 cases). The incidence of liver injury The difference was not statistically significant (χ2 = 1.398, P> 0.05). There were 134 high-risk patients with liver injury, 86 with hepatoprotective drugs, 15.1% with hepatic injury (n = 13), 48 with no hepatoprotective drugs, and 25.0% with hepatic injury (n = 12) No statistical significance (χ2 = 1.983, P> 0.05). There were 65 cases of compound glycyrrhizin, the incidence of hepatic injury was 13.8% (9 cases), the use of reduced glutathione 57 cases, the incidence of liver injury was 12.3% (7 cases), there was no significant difference between the two groups (χ2 = 0.001, P> 0.05). Conclusion The prevention of liver damage caused by antituberculosis drugs in patients with AIDS / TB is not significant, and the treatment plan needs to be flexible.