双环醇对抗结核药物肝损伤预防疗效的观察.docVIP

精品论文 参考文献 双环醇对抗结核药物肝损伤预防疗效的观察 姬宝军 王金珂 　　（河南省濮阳市第五人民医院内一科，河南 457000） 　　[摘要] 目的 评价双环醇对抗结核药物肝损伤的预防效果和是否影响抗结核药物的疗效。方法 随机将1，536例初治涂阳肺结核患者分为试验组（768例）和对照组（768例），两组均采用2HRZE（或S）/4HR方案抗结核治疗，试验组加用双环醇片25mg，tid,po连用6个月。观察两组患者总肝损伤情况；中重度肝损伤情况；疗程结束时痰菌阴转情况；停药随访24个月痰菌复发情况。 结果 疗程结束时总肝损伤的发生率，试验组为8.98%（69/768），对照组为23.57%（181/768），两组有显著性差异（Plt;0.05）；中、重度肝损伤发生率，试验组为3.13%（24/768），对照组为11.46%（88/768），两组有显著性差异（Plt;0.05）；疗程结束时痰菌阴转率，试验组为98.05%（753/768），对照组为97.14%（746/768），两组无显著性差异（Pgt;0.05）；停药观察随访24个月痰菌复发率，试验组1.99%（15/753），对照组10.05%（75/746），两组有显著性差异（Plt;0.05）。结论 双环醇能预防抗结核药物的肝损伤，同时不影响抗结核药物的疗效，还能减少患者的不规则服药率，降低患者治愈后的复发率。 　　[关键词]结核；肺/药物治疗；肝损伤/药物预防；双环醇 　　Curative effect of bicyclol on preventing liver injury induced by antituberculosis drugs. 　　[Abstract]Objective: To evaluate the effect of bicyclol in preventing drug-induced liver injury in tuberculosis and whether it affects the clinical efficacy of antituberculosis durgs. Methods: A total of 1536 initially smear-positive pulmonary tuberculosis(TB) patients were randomised divided into test group (768 cases) and control group (768 cases), both groups were treated with 2HRZE (or S) / 4 HR anti-tuberculosis treatment, and test group was given bicyclol tablets (25 mg three times daily, 6 months)additionally. The liver injury, sputum negative conversion at the end of the course and sputum bacteria relapse during the course discontinuation for 24 months was observed and compared. Results: At the end of the course, the incidence of liver injury and the rate of moderate or severe liver injury in test group were 8.98% (69/768) and 3.13%（24/768）, which were significant lower than 23.57% (181/768) and 11.46%（88/768）in control group (P lt; 0.05); Whereas, there was no significant difference of the sputum negative conversion rate between the test group and control group(98.05% vs 97.14%)(Pgt; 0.05); At the course discontinuation for 24 months,the rate of sputum bacteria relapse was1.99%（15/753）in test group, 10.05%（75/746）in the control group, which ha