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目的探讨抗结核药物所致药物性肝炎的临床特点及预防策略。方法对210例抗结核药物所致药物性肝炎患者的临床资料进行回顾性分析。结果抗结核药物所致药物性肝炎以肝细胞损伤型为主(64.8%);其中,轻、中度肝损害占76.2%,重度肝损害占23.8%。合并基础肝病者占48.0%,更易发生药物性肝炎。其中,合并乙肝病毒感染者发生率最高(35.7%)。结论有肝脏基础疾病患者发生药物性肝炎比率高;在评估肝脏基本状况的基础上制定合适的抗结核方案和监测肝功能是预防药物性肝炎的重要策略。
Objective To investigate the clinical features and preventive strategies of drug-induced hepatitis caused by anti-TB drugs. Methods The clinical data of 210 patients with drug-induced hepatitis due to anti-TB drugs were retrospectively analyzed. Results The drug-induced hepatitis induced by anti-TB drugs was mainly hepatocellular injury (64.8%). Among them, mild to moderate hepatic injury accounted for 76.2% and severe hepatic injury accounted for 23.8%. 48.0% of patients with basic liver disease, more prone to drug-induced hepatitis. Among them, the incidence of hepatitis B virus infection was the highest (35.7%). Conclusion There is a high incidence of drug-induced hepatitis in patients with liver-related diseases. It is an important strategy to prevent drug-induced hepatitis based on the assessment of the basic condition of liver and to develop appropriate anti-TB regimens and monitor liver function.