【摘要】 目的　探讨抗结核药物应用过程中产生的肝损害问题。方法　对1995年1月至2002年12月住院的1 464例肺结核病患者中应用抗结核药物后出现肝损害的172例患者进行回顾性分析。结果　抗结核药物肝损害的高发年龄为20~60岁,占70 .3%,消化道症状出现和肝功能改变发生于用药后8周内强化治疗期的占73. 8%,轻者加保肝药治疗可不需停用抗结核药物,重者须停药并着重保肝治疗。157例(91 .3% )恢复正常, 13例(7 .6% )好转, 2例恶化出院, 41例( 23. 8% )需减量或停药,对化疗效果产生影响。结论　应用抗结核药物易发生肝损害,体重<50kg的老年男性、既往已有肝损害或嗜肝病毒感染、饮酒、合并肺外疾病、异烟肼、利福平、吡嗪酰胺三药联用等为易感因素。更多还原

【Abstract】 Objective To study problems related to drug-induced liver lesion caused by antituberculotic therapy (DLL).Methods Totally, 172 cases of DLL occurred in 1 464 patients with pulmonary tuberculosis after antituberculotic therapy, hospitalized during January 1995 to December 2002, were reviewed and analyzed retrospectively.Results Patients aged 20 to 60 years with DLL by antituberculolis therapy accounted for 70.3% of the total. Symptoms of digestive tract and change in liver function usually occurred within 8 weeks of intensive treatment (73.8%), and discontinuation of autituberculotic drugs was not needed for the mild cases, but needed for the severe cases with liver protective therapy. In total, 157 of the 172 cases (91.3%) recovered completely and 13 case improved (7.6%), two cases deteriorated and discharged, and doses of autituberculotic drugs should be reduced or stopped in 41 cases (23.8%) affecting their treatment efficacy.Conclusions DLL was liable to occur in patients of pulmonary tuberculosis with antituberculotic therapy, especially in the elderly men with body weight less than 50 kilograms, those with previous liver damage or infected with hepatotropic virus, alcohol drinking, complicated with extrapulmonary tuberculosis, with combination of isoniazid rifampicin and pyrazinamide.更多还原