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目的:探讨抗结核药物致药物性肝炎的患病规律及临床特点。方法:回顾性分析2010年1月至2014年1月揭阳市揭东区慢性病防治中心收治的767例肺结核患者的临床资料。结果:在767例肺结核患者中出现药物性肝炎73例,男43例,女30例;年龄15~64岁,平均年龄(41.28±5.89)岁,30岁以下12例、30~50岁28例、50岁以上33例。血行播散型肺结核27例、继发性肺结核32例、结核性胸膜炎24例。初治结核56例、复治结核患者17例。HBV-M(1、3、5)阳性者39例、HBV-M(1、4、5)阳性者18例、HBV-M阴性者16例。肝功能损害时间<10 d者19例、10~30 d者38例、>30 d者16例。肝功能轻度异常11例、中度异常43例(58.90%)、重度异常19例(26.03%)。抗结核治疗强化期内出现药物性肝炎60例、巩固期内出现药物性肝炎13例。所有患者出现药物性肝炎后,即刻停用抗结核药物等,予护肝药物治疗,67例患者在1个月内肝功能恢复正常,反复迁延不愈者4例,重症性肝炎2例。结论:抗结核药物治疗肺结核过程中常出现药物性肝炎,应早期发现、早期诊断、早期治疗,有效预防并发症的发生。
Objective: To investigate the prevalence and clinical features of drug-induced hepatitis induced by anti-tuberculosis drugs. Methods: The clinical data of 767 tuberculosis patients admitted to Jidong District Chronic Disease Prevention and Cure Center from January 2010 to January 2014 in Jieyang City were retrospectively analyzed. Results: There were 73 cases of drug-induced hepatitis in 767 tuberculosis patients, including 43 males and 30 females. The average age was 41.28 ± 5.89 years old, 12 cases were below 30 years old and 28 cases were 30-50 years old. , 33 cases over the age of 50. Hematogenous disseminated pulmonary tuberculosis in 27 cases, 32 cases of secondary tuberculosis, tuberculous pleurisy in 24 cases. 56 cases of newly diagnosed tuberculosis and 17 cases of retreatment tuberculosis. There were 39 cases of HBV-M (1,3,5) positive, 18 cases of HBV-M (1,4,5) positive and 16 cases of HBV-M negative. 19 cases of liver damage less than 10 days, 38 cases of 10 ~ 30 days, 16 cases> 30 days. Eleven patients had mild liver dysfunction, 43 patients (58.90%) had moderate abnormality, and 19 patients (26.03%) had severe abnormality. Anti-TB treatment of drug-induced hepatitis in 60 cases during the consolidation period, there were 13 cases of drug-induced hepatitis in the consolidation period. All patients with drug-induced hepatitis, immediate withdrawal of anti-TB drugs, to protect the liver drug treatment, 67 patients within 1 month of liver function returned to normal, repeated delayed unhealed in 4 cases, 2 cases of severe hepatitis. Conclusion: Anti-tuberculosis drugs often appear in the process of tuberculosis drug-induced hepatitis, early detection, early diagnosis, early treatment, the effective prevention of complications.