合并乙型肝炎病毒感染的肺结核患者抗痨化疗对肝功能的影响  

Liver function changes during antituberculosis chemotherapy in patients of pulmonary tuberculosis complicated by HBV infection

作　　者：王卫兵[1] 卢柏安[1] 王春莉[1] 袁福兵[1] 刘健虎[1] 

机构地区：[1]第101医院

出　　处：《南京部队医药》2000年第3期3-4,共2页

摘　　要：目的了解肺结核合并乙型肝炎病毒(HBV)感染患者抗痨化疗中肝功能受药物的影响。方法应用酶联免疫吸附试验(ELISA)检测血清乙型肝炎病毒标志物(HBV-M),并用全自动生化分析仪检则肺功能。采用以异烟肼、利福平为主的化疗方案治疗肺结核。结果 73例合并 HBV 感染的肺结核患者用药后,肝功能受损率达53.4%,而不合并 HBV 感染的单纯肺结核患者的肝功能受损率为9.1%,两者间差异显著,(P<0.01)。HBeAg 阳性组的肝功能受损率达80%,与 HBeAg 阴性组相比,差异显著(P<0.05)。改用对肝功能损害较轻的抗结核药物,并积极行保肝治疗,大部分患者的病情缓解,1例死于肝功能衰竭。结论肺结核合并 HBV 感染的患者,在抗痨化疗过程中,容易出现肝功能损害,病毒有复制者尤其如此。故尔对抗痨化疗方案应作适当调整,并要加强保肝治疗,密切观察肝功能的变化。Objective In order to understand the ill effect of the antituberculosis drugs to the liver function in the course of chemotherapy in the patients of the pulmonary tuberculosis complicated by hepatitis B virus (HBV) infection.Methods the HBV- M were determined with the automatic biochemical analyzer.Isoniazide and rifampin were adopted in the treatment of pulmonry tu- berculosis patients.Results There were 73 cases complicated by HBV infection in 468 cases of pulmonary tuberculosis patients. After medication,the abnormal liver function rate turned to be 53.4 % in the positive HBV group,and 9.1% in the negative group (P<0.01).The abnormal liver function rate reached 80% in the positive HBeAg group as compared with the negative HBeAg group with significant differences between the 2 groups,P<0.05.The symptoms of the most patients with abnormal liver function were relieved after liver protecting treatment,with one case died of liver function failure.Conclusion The abnormal liver function is apt to appear during the antituberculous chemotherapy for patients of pulmonary tuberculosis complicated by HBV infection,es- pecialy in the positive HBeAg group.The antituberculosis medication plan should be adjusted appropriately,while the liver protect- ing treatment be strengthened and the changes of the liver function should be observed closely.

关 键 词：肺结核患者 乙型肝炎 病毒感染 肝功能 

分 类 号：R521[医药卫生—内科学] R512.62[医药卫生—临床医学]