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目的探讨肺结核化疗引起肝功能损害的多因素。方法收集继发型肺结核患者215例的临床资料,建立Excel数据库。对性别、年龄、分类(初治、复治)、血红蛋白、两对半(HBsAg、HBsAb、HBeAg、HBeAb、HbcAb)、治疗前肝功能、白蛋白、抗结核药、护肝药、治疗后肝功能等进行单因素相关分析和多因素Logistic回归分析。结果(1)单因素相关分析表明,继发型肺结核患者的HBsAg、HbcAb、白蛋白与抗结核治疗后肝功能异常相关。(2)多因素Logistic回归分析结果提示白蛋白与抗结核治疗后肝功能异常相关。结论为减少药物性肝功能损害的发生,对合并HBV感染的肺结核患者抗结核治疗时,应密切监测其肝功能,加强护肝治疗;对合并低蛋白血症肺结核病患者治疗时,注意监测其肝功能及改善其低蛋白血症的状态。
Objective To investigate the multifactorial factors of liver function damage caused by pulmonary tuberculosis chemotherapy. Methods The clinical data of 215 patients with secondary pulmonary tuberculosis were collected and an Excel database was established. Pre-treatment liver function, albumin, antituberculosis drugs, hepatoprotective drugs, post-treatment liver disease were analyzed for gender, age, classification (initial treatment, retreatment), hemoglobin, Function and other single factor correlation analysis and multivariate Logistic regression analysis. Results (1) Univariate correlation analysis showed that HBsAg, HbcAb and albumin in patients with secondary pulmonary tuberculosis were associated with abnormal liver function after anti-TB treatment. (2) Multivariate Logistic regression analysis showed that albumin was associated with abnormal liver function after anti-TB treatment. Conclusion In order to reduce the occurrence of drug-induced liver dysfunction, tuberculosis patients with HBV infection should be closely monitored for their liver function and hepatoprotective therapy. In the treatment of patients with pulmonary tuberculosis complicated with hypoproteinemia, attention should be paid to monitoring their liver function Liver function and improve their hypoproteinemia state.