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结核病是威胁人类健康的慢性传染病之一,全世界每年仍有1千万新发病例,约300万人因结核病死亡。实践证明,只要坚持全程正规治疗,绝大多数患者是可以治愈的。但在治疗的过程中,采用DOTS策略,必须联合应用抗痨药物,最常见的不良反应即肝损害。药物性肝损伤即药物及其代谢产物引起的肝脏损害,以乏力、纳差、尿黄、恶心及右上腹不适为主,部分可出现黄疸。因此,抗痨治疗的同时需要服用保肝药,且密切监测肝功。严重的肝损伤可导致化疗中断,甚至患者可因肝功能衰竭而死亡。本文综述了抗痨药物肝损伤及保肝药物的应用、药物性肝损伤的相关危险因素以及抗痨药物肝损伤的防治进展,对改善患者的肝损伤程度,减轻患者的负担,实现全程督导化疗具有重要的意义。
Tuberculosis is one of the chronic infectious diseases that threaten human health. There are still 10 million new cases every year in the world and about 3 million people die of tuberculosis. Practice has proved that as long as the full adherence to the regular treatment, the vast majority of patients can be cured. However, in the treatment process, the use of DOTS strategy, the joint application of anti-tuberculosis drugs, the most common adverse reactions that liver damage. Drug-induced liver injury that caused by drugs and their metabolites of liver damage to fatigue, anorexia, urinary yellow, nausea and right upper quadrant discomfort mainly part of jaundice may occur. Therefore, anti-tuberculosis treatment at the same time need to take liver medicine, and close monitoring of liver function. Severe liver damage can lead to an interruption of chemotherapy, and even patients can die of liver failure. This article reviews the anti-tuberculosis drugs liver injury and the application of hepatoprotective drugs, drug-related liver injury risk factors and anti-tuberculosis drug liver damage prevention and treatment progress, to improve the degree of liver damage in patients and reduce the burden on patients to achieve full supervision and chemotherapy It is of great significance.