新疆结核病患者化疗过程中肝酶异常的影响因素  

Influential Factors for Effects of Chemotherapy on Abnormal Plasma Liver Enzymes of Tuberculosis Patients in Xinjiang during Chemotherapy

作　　者：秦丽岩[1] 李瑞[1] 杨建东[1] 马晨晨[1] 祖丽娅.沙塔尔 蒋博峰[1] 向阳[1] 

机构地区：[1]新疆医科大学公共卫生学院,乌鲁木齐830011

出　　处：《中国药房》2016年第2期216-218,共3页China Pharmacy

基　　金：国家自然科学基金资助项目(No.30960328);新疆医科大学大学生创新项目(No.CX2015065)

摘　　要：目的：评价新疆结核病患者化疗过程中肝酶异常的影响因素。方法：选择2010年2月-2012年8月新疆阿克苏、伊犁地区和乌鲁木齐市天山区接受化疗的初治结核病患者1 746例,收集患者年龄、性别、是否购买医疗保险及是否预防性服用保肝药物等临床资料并随访至强化期末,进行肝功能检测,采集患者血样进行甲、乙、丙型病毒性肝炎血清表面标志物及药物代谢酶细胞色素P450（CYP）2E1基因Rsa I位点多态性的检测。结果：共233例患者肝酶异常,肝酶异常的发生率为13.34%[95%CI（11.75%~14.93%）]。非条件Logistic回归分析显示,预防性服用保肝药物是肝酶异常的危险因素[OR=1.947,95%CI（1.464~2.589）];女性[OR=0.699,95%CI（0.522~0.936）]和购买医疗保险[OR=0.551,95%CI（0.413~0.734）]是肝酶异常的保护因素;不同CYP2E1基因Rsa I位点的患者间肝酶异常的发生率比较,差异无统计学意义（P〉0.05）。结论：结核病患者肝酶异常发生率较高,治疗过程中应加强肝功能检查,尽早预防可能发生的肝损害,以保证结核病防治策略的顺利实施。OBJECTIVE：To evaluate the effects of chemotherapy on abnormal plasma liver enzymes of tuberculosis patients in Xinjiang.METHODS：1 746 tuberculosis patients receiving chemotherapy were collected from Xinjiang Aksu and Yili area and Urumqi Tianshan District during Feb.2010-Aug.2012.Clinical information of patients ages,gender,whether the purchace of in surance and the use of hepatoprotective drugs were collected and followed up,and liver function was detected at the end of enhancement period.Blood sample of patients were collected to detect virus hepatitis A,B and C blood serum marker and Rsa I site polymorphism of P450CYP2E1.RESULTS：There were 233 patients with abnormal plasma liver enzymes,and the incidences of abnormal plasma liver enzymes were 13.34%[95%CI（11.75%-14.93%）].Unconditioned Logistic regression analysis showed that prophylactic liver-protective medicine was risk factor to abnormal plasma liver enzymes [OR=1.947,95%CI（1.464-2.589）];the positive factor of abnormal plasma liver enzymes was associated with female [OR=0.699,95%CI（0.522-0.936）] and health insurance payment [OR=0.551,95%CI（0.413-0.734）].CYP2E1 gene Rsa I site polymorphism couldn＇t increase the risk of abnormal plasma liver enzymes,without statistical significance（P〉0.05）.CONCLUSIONS：There is a high incidence of abnormal plasma liver enzymes in TB patients,and liver function examination should be strengthened in the treatment,as soon as possible to prevent the occurrence of hepatotoxicity,to ensure the smooth implementation of tuberculosis control strategy.

关 键 词：新疆 结核病 肝酶异常 影响因素 

分 类 号：R52[医药卫生—内科学] R181.3[医药卫生—临床医学]