老年肺结核患者抗结核药物性肝损害的预防探讨  

Study on anti-tuberculosis therapeutic regimen in the older patients with pulmonary tuberculosis to reduce drug-induced hepatotoxicity

作　　者：安慧茹[1] 王仲元[1] 吴雪琼[1] 徐静[1] 郑少华[1] 王坤[1] 

机构地区：[1]解放军309医院全军结核病研究所,北京100091

出　　处：《四川医学》2012年第11期1875-1876,共2页Sichuan Medical Journal

基　　金：北京市科技计划研发攻关类科研基金资助项目(编号:D08050700640802)

摘　　要：目的探讨老年菌阳肺结核患者采取预防措施(强化期化疗方案及用药剂量的调整)对药物性肝损害的发生率的影响。方法回顾性分析我院1998年1月1日～2008年12月31日收治的老年初治菌阳肺结核患者305例。对比观察采取预防治疗组与常规治疗组(未采取措施组)患者药物性肝损害的发生率及痰菌转阴率。结果采取预防治疗组151例,其中出现肝损害15例(9.9%),常规治疗组154例,其中出现肝损害35例(22.7%),预防治疗组肝损害发生率明显低于常规治疗组(P<0.01)。2个月痰涂片抗酸杆菌转阴率分别为60.3%和67.5%,差异无统计学意义(P>0.05)。结论对老年痰菌阳性肺结核患者,应适当调整抗结核化疗方案及用药剂量,可以减少药物性肝损害的发生率,且不影响痰菌阴转率。Objective To evaluate the effect on drug-induced hepatotoxicity in the older patients with pulmonary tuberculosis with adjusted measures when anti-tuberculosis agent was given.Methods This retrospective study inclding 305 older patients,who hospitalized in our hospital from January 1,1998 to December 31,2008,with initial treatment smear positive pulmonary tuberculosis was performed.The incidence of drug induced hepatotoxicity and the rate of sputum smear negative conversion were analyzed between the group patients with adjusted measures and the group patient s without adjusted measures when they were given with first line anti-tuberculosis agent.Results There were only 15 patients developed into drug induced hepatotoxicity in 151 patients with adjusted measures.However,35 patients developed into drug induced hepatotoxicity in 154 patients without adjusted measures when given with anti-tuberculosis agent.The rate of drug induced hepatotoxicity among the group patients with adjusted measures was lower than that of group patients without adjusted measures with statistically significant difference(P<0.01).But the rate of sputum smear negative conversion after two months treatment were 60.3% and 67.5% between two group patients withno statistically significant difference(P>0.05).Conclusion Adjusted measures should be performed in older patients with pulmonary tuberculosis to reduced antdrug-induced hepatotoxicity.

关 键 词：肺结核 老年人 药物性肝损害 

分 类 号：R521[医药卫生—内科学]