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目的分析初治涂阳肺结核患者抗结核治疗过程出现肝损害的程度及特点,探讨采取应对肝损害的措施。方法选取三明市梅列区、三元区2006—2010年规则抗结核治疗的初治涂阳肺结核患者454例,观察治疗过程出现的肝损害并分析其特点。结果患者肝损害率为14.1%(64/454),主要是ALT升高,中、轻度及以下肝损害占85.9%,重度以上肝损害仅占14.0%;不同性别及年龄的肝损害无明显差异。结论抗结核药引起肝损害在不同性别及年龄间无统计学意义。临床医生要充分掌握抗结核药物的不良反应并做好监测,包括对患者进行宣传教育,及时采取相应措施,确保病人能规则完成治疗,保障病人用药安全,避免发生医患纠纷。
Objective To analyze the degree and characteristics of liver damage in newly smear-positive pulmonary tuberculosis patients during anti-TB treatment and to explore measures to deal with liver damage. Methods 454 primary smear-positive pulmonary tuberculosis patients with regular anti-tuberculosis treatment in Meiling District and Sanyuan District from 2006 to 2010 in Sanming District were selected. The liver damage occurred during the treatment and the characteristics were analyzed. Results The rate of liver injury in patients was 14.1% (64/454), mainly elevated ALT, 85.9% of moderate and mild liver damage and only 14.0% of severe liver injury, and no significant difference in liver damage between different sexes and ages difference. Conclusion The liver damage caused by anti-TB drugs has no statistical significance in different genders and ages. Clinicians should fully grasp the adverse reactions of antituberculosis drugs and do a good job of monitoring, including publicity and education of patients, and timely measures to ensure that patients can complete the treatment in a regular manner to ensure the safety of patients and avoid medical disputes.