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目的观察不同程度低蛋白血症患者抗结核治疗过程中药物性肝功能损害。方法对在本院住院治疗,合并低蛋白血症的167例初治肺结核患者,根据治疗前血清白蛋白水平(ALB<35g/L,ALB<30g/L,ALB<25g/L)分为轻、中、重3组为病例组。采用标准抗结核药物治疗方案,观察药物性肝损害情况;并设同期住院治疗的不合并低蛋白血症的初治肺结核患者216例为对照组。结果 4组患者肝功能ALT、AST、TBIL升高的程度对照组与轻、中、重度低蛋白血症组比较,有显著差异(P<0.05)。4组患者的血清ALB水平与其肝功能ALT、AST、TBIL升高的程度均呈负相关(r分别为-0.978,-0.970,-0.980;P分别为0.022,0.030,0.020,P均<0.05)。但出现肝功能损害的时间比较不存在显著差异性(P>0.05)。结论在抗结核的治疗过程中,低蛋白血症患者的药物性肝损害程度更重。
Objective To observe the drug-induced liver dysfunction during anti-TB treatment in patients with different degrees of hypoproteinemia. Methods A total of 167 patients with newly diagnosed pulmonary tuberculosis who were hospitalized and had hypoproteinemia in our hospital were divided into three groups according to pretreatment serum albumin (ALB <35g / L, ALB <30g / L, ALB <25g / L) , Medium and heavy 3 groups for the case group. Standard anti-tuberculosis drug treatment program was used to observe the situation of drug-induced liver damage. In the same period, 216 untreated tuberculosis patients with hypoproteinemia were enrolled as the control group. Results The levels of ALT, AST and TBIL in liver function in the four groups were significantly different from those in the mild, moderate and severe hypoproteinemia groups (P <0.05). Serum ALB levels in 4 groups were negatively correlated with the levels of ALT, AST and TBIL (r = -0.978, -0.970, -0.980, P = 0.022,0.030,0.020 respectively, all P <0.05) . However, there was no significant difference in the time of liver damage (P> 0.05). Conclusion In the treatment of anti-tuberculosis, hypoproteinemia in patients with drug-induced liver damage is more serious.