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目的探讨肺结核患者应用抗结核药物所致药物性肝损害的临床特点并分析相关危险因素,为临床预防和治疗抗结核药物性肝损害提供一定依据。方法选择2013年1月至2016年6月期间我院收治的563例肺结核患者为研究对象,对其中65例药物性肝损害患者的潜在危险因素进行统计学分析。结果抗结核药物所致肝损害的发生率为11.5%(65/563)。其中,男性与女性患者肝损害发生率,差异无统计学意义(P>0.05);老年与中青年患者肝损害发生率,差异有统计学意义(P<0.05)。另外,HBs Ag阳性患者、复发患者、过量饮酒患者、治疗3个月内肝损害发生率均明显升高(P均<0.05)。而吸烟、营养不良患者的肝损害发生率分别与不吸烟、营养正常患者相比差异无统计学意义(P>0.05)。结论肺结核患者药物性肝损害发病率与老年、HBs Ag阳性、复发、过量饮酒等危险因素密切相关,应密切关注具有相关危险因素人群的肝功情况,及早发现、预防和治疗,采取适当措施以避免或减少肝损害的发生。
Objective To investigate the clinical features of drug-induced liver damage caused by anti-tuberculosis drugs in patients with pulmonary tuberculosis and to analyze the related risk factors so as to provide some evidences for clinical prevention and treatment of anti-TB drug-induced liver damage. Methods A total of 563 pulmonary tuberculosis patients admitted to our hospital from January 2013 to June 2016 were enrolled in this study. The potential risk factors of 65 patients with drug-induced liver damage were statistically analyzed. Results The incidence of liver damage caused by anti-TB drugs was 11.5% (65/563). Among them, there was no significant difference in the incidence of liver damage between male and female patients (P> 0.05). The incidence of liver damage in elderly and middle-aged patients was significantly different (P <0.05). In addition, HBsAg-positive patients, relapse patients, excessive drinking patients, the incidence of liver damage within 3 months were significantly increased (all P <0.05). However, the prevalence of liver damage in smokers and malnutrition patients was significantly higher than that in non-smokers and normotensives patients (P> 0.05). Conclusions The incidence of drug-induced liver damage in patients with tuberculosis is closely related to the risk factors such as old age, HBs Ag positive, recurrence, excessive alcohol consumption and so on. Therefore, we should pay close attention to the liver function of the population with relevant risk factors, find out, prevent and treat as soon as possible and take appropriate measures Avoid or reduce the occurrence of liver damage.