抗结核药物引起肝功能损害及其他不良反应动态监测.doc

抗结核药物引起肝功能损害及其他不良反应动态监测[摘要] 目的 动态监测肺结核患者的抗结核药物引起肝功能损害及其他不良反应发生率及其影响因素。方法 用前瞻性研究方法系统地观察我院2年内诊治的所有初治涂阳肺结核患者抗结核药物引起肝功能损害及其他不良反应发生率及其影响因素。结果 84例肝功能损害及265例其他不良反应;肝功能轻度异常52例(4.96%),中度异常26例(2.48%),重度异常6例(0.57%)。265例不良反应中,发热96例(9.16%),有胃肠道症状、恶心、呕吐61例(5.82%),血尿酸增高32例(3.05%),头晕19例(1.81%)、皮疹12例(1.14%),其他24例(2.29%)。结论 抗结核药易引起药物性肝炎,用药期间应注意肝功能检测及其他不良反应,对存在高危因素的患者应注意用药。 [关键词] 肝炎; 药物性; 抗结核药; 不良反应 [中图分类号] R978.3;R575 [文献标识码] A [文章编号] 1673-9701(2010)03-45-02 Dynamic Monitoring of Anti-TB Drug-induced Liver Function Damage and Other Adverse Reactions MEI Yuezhi YANG Liming Dongguan Municipal Hospital of Chronic Diseases,Dongguan 523008,China [Abstract] ObjectiveTo dynamically monitor the incidence and influencing factors of anti-TB drug-induced liver function damage and other adverse reactions in TB patients. MethodsA prospective analysis was made to systematically observe the incidence and influencing factors of anti-TB drug-induced liver function damage and other adverse reactions of all newly smear-positive TB patients treated in the past two years at our hospital. ResultsEighty-four cases showed damages to liver functions including 52 cases(4.96%) of mildly abnormal liver function,26 cases(2.48%)of moderate abnormality,6 cases(0.57%)of severe abnormality ,and 265 cases of other adverse reactions including 96 cases of fever(9.16%),61 cases(5.82%)of gastrointestinal symptoms,nausea and emesis,32 cases(3.05%)of increased blood uric acid,19(1.81%)cases of dizziness,12 cases(1.14%)of skin rash and 24 other cases(2.29%). ConclusionAnti-TB drugs easily cause drug-induced hepatitis. It is important to examine liver functions and other adverse reactions during the period of medication. Individualized medication is necessary for the patients with high-risk factors. [Key words]Hepatitis; Drug induced; Anti-TB drugs; Adverse reactions 药物性肝损害(druginduced liver injury)是指用药过程中肝脏因受药物的直接或间接作用而发生的功能和结构的损害,文献报道抗结核药物引起的不良反应发生率平均为12.6%[1]。现将我院2006~2008年收治的抗结核过程中所出现的肝功能损害84例及265